Electronic monitoring and mental health

Producing a continual digital record of everyday life, lifelogging, has during the recent years received great interest. Many people use various types of electronic devices for lifelogging with detailed and continuous tracking of physical and mental status and is generally viewed as an empowering tool with ‘self-knowledge through self-tracking with technology’.

In psychiatry, the number of patients who do not receive treatment for their disorder is between 35–50% in high-income countries and 76–85% in low- and middle-income countries. There is a worldwide gap between the number of patients needing treatment and the number of available clinicians. Notably, the World Health Organization stated in 2011 that ‘the use of mobile and wireless technologies to support the achievement of health objectives (mHealth) has the potential to transform the face of health service across the globe’ [1]. mHealth technologies may potentially assist in this gap in available clinicians. Due to the limited access to treatment facilities, during recent years, and especially emphasized during the COVID-19 pandemic and log-down, there has been an rapid increase in the international interest on the potential and importance in advancing the use of various mHealth technologies for both monitoring and treatment within mental health [2]. Interest in mHealth science in mental health research has been further heightened by the widely acknowledged need for improved fine-grained characterization, diagnostic precision and individualized risk prediction, long-term monitoring and treatment. Using fine-grained electronically, often unobtrusively, collected patient-reported and more automatically generated data using various mHealth technologies to tackle complex mental health problems is found to be a key research priority moving forward [3]. It has been suggested that mHealth solutions potentially could lead to a more efficient use of clinical resources in today’s health care system, which in turn can lead to a more equitable distribution of resources. However, despite many mHealth technologies are developing at an enormous speed, most of these solutions, often driven by private initiatives, have not been scientifically investigated. Despite the hype, the validity, treatment effects (both positive and negative), and safety has been sparingly investigated in scientific studies [4]. Heterogeneity and methodological issues, including lack of information on the technology used and statistical approaches, in individual studies limit the evidence. As an example, within bipolar disorder studies investigating the use of smartphones for fine-grained monitoring, classification of affective states, diagnosing and treatment have been published [5]. These studies suggest that smartphone-based, both patient-reported and automatically generated data, may reflect clinically evaluated depressive and manic symptoms, differentiate between patients and healthy control individuals and may reduce patient-reported perceived stress when used as a treatment intervention.

In the present volume of the Nordic Journal of Psychiatry, Freyberg et al. present data from an interesting study including patients with newly diagnosed bipolar disorder, where physical activity measured using paper-based questionnaires was compared with objectively measured physical activity with an mHealth technology. There is a need to identify objective measures relevant to diagnosis, monitoring and early treatment intervention in psychiatry. Using mHealth technologies enables the collection of fine-grained data over long-term in naturalistic settings that may identify underlying pathophysiological processes and provide markers and potential treatment interventions. Ultimately, such markers could be used as outcome measures in future efficacy trials. Overall, to move this emerging area forward, more studies addressing various aspects within this area with strict methodological standards when designing, conducting, and reporting findings are warranted.

Disclosure statement

No potential conflict of interest was reported by the author(s).