Smartphone-based interventions in bipolar disorder: Systematic review and meta-analyses of efficacy. A position paper from the International Society for Bipolar Disorders (ISBD) Big Data Task Force
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Background: The clinical effects of smartphone-based interventions for bipolar disorder (BD) have yet to be established. Objectives: To examine the efficacy of smartphone-based interventions in BD and how the included studies reported user-engagement indicators. Methods: We conducted a systematic search on January 24, 2022, in PubMed, Scopus, Embase, APA PsycINFO, and Web of Science. We used random-effects meta-analysis to calculate the standardized difference (Hedges’ g) in pre-post change scores between smartphone intervention and control conditions. The study was pre-registered with PROSPERO (CRD42021226668). Results: The literature search identified 6034 studies. Thirteen articles fulfilled the selection criteria. We included seven RCTs and performed meta-analyses comparing the pre-post change in depressive and (hypo)manic symptom severity, functioning, quality of life, and perceived stress between smartphone interventions and control conditions. There was significant heterogeneity among studies and no meta-analysis reached statistical significance. Results were also inconclusive regarding affective relapses and psychiatric readmissions. All studies reported positive user-engagement indicators. Conclusion: We did not find evidence to support that smartphone interventions may reduce the severity of depressive or manic symptoms in BD. The high heterogeneity of studies supports the need for expert consensus to establish ideally how studies should be designed and the use of more sensitive outcomes, such as affective relapses and psychiatric hospitalizations, as well as the quantification of mood instability. The ISBD Big Data Task Force provides preliminary recommendations to reduce the heterogeneity and achieve more valid evidence in the field.
| Original language | English |
|---|---|
| Journal | Bipolar Disorders |
| Volume | 24 |
| Issue number | 6 |
| Pages (from-to) | 580-614 |
| ISSN | 1398-5647 |
| DOIs | |
| Publication status | Published - 2022 |
Bibliographical note
Funding Information:
GA has received CME‐related honoraria, or consulting fees from Janssen‐Cilag, Lundbeck, Lundbeck/Otsuka, and Angelini with no financial or other relationship relevant to the subject of this article. DHM received CME‐related honoraria from Abbott and Angelini with no financial or other relationship relevant to the subject of this article. EB has received research grants or research support from FAPESP, CNPq, and CAPES (Brazilian Government), from the Southeastern Ontario Academic Medical Association (SEAMO), from Faculty of Health Sciences, Queen's University and from a L'Oreal/UNESCO/Brazilian Academy of Sciences for Women in Science Award. She has received honorarium as consultant/advisory board member from Daiichi‐Sankyo. ICP has received research support from or served as consultant, adviser or speaker for Lundbeck, EMS, Libbs, and receives authorship royalties from Springer Nature and ArtMed. LNY has been a consultant and/or has received speaker fees and/or sat on the advisory board and/or received research funding from Abbvie, Alkermes, Allergan, Canadian Network for Mood and Anxiety Treatments (CANMAT), Canadian Institutes of Health Research (CIHR), Dainippon Sumitomo Pharma, Gedeon Richter, GSK, Intracellular Therapies, Lundbeck, Merck, Otsuka, Sanofi and Sunovion over the past 3 years. RWL has received honoraria for ad hoc speaking or advising/consulting, or received research funds, from Allergan, Asia‐Pacific Economic Cooperation, BC Leading Edge Foundation, Canadian Institutes of Health Research, Canadian Network for Mood and Anxiety Treatments, Healthy Minds Canada, Janssen, Lundbeck, Lundbeck Institute, Michael Smith Foundation for Health Research, MITACS, Myriad Neuroscience, Ontario Brain Institute, Otsuka, Pfizer, Unity Health, and VGH‐UBCH Foundation. RSM has received research grant support from CIHR/GACD/Chinese National Natural Research Foundation; speaker/consultation fees from Lundbeck, Janssen, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Sunovion, Bausch Health, Novo Nordisk, Kris, Sanofi, Eisai, Intra‐Cellular, NewBridge Pharmaceuticals, Abbvie. RM is a CEO of Braxia Scientific Corp and has received research grant support from CIHR/GACD/Chinese National Natural Research Foundation; speaker/consultation fees from Lundbeck, Janssen, Alkermes, Mitsubishi Tanabe, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Sunovion, Bausch Health, Novo Nordisk, Kris, Sanofi, Eisai, Intra‐Cellular, NewBridge Pharmaceuticals, Abbvie. EV has received research support from or served as consultant, adviser, or speaker for AB‐Biotics, Abbott, Allergan, Angelini, Dainippon Sumitomo Pharma, Ferrer, Gedeon Richter, Janssen, Lundbeck, Otsuka, Sage pharmaceuticals, Sanofi‐Aventis, Shire, Sunovion, Takeda, and reports no financial or other relationship relevant to the subject of this article. All other authors report no financial or other relationship relevant to the subject of this article. LVK has during the recent 3 years been a consultant for Lundbeck and Teva.
Funding Information:
Gerard Anmella is supported by a Rio Hortega 2021 grant (CM21/00017) from the from Spanish Ministry of Health financed by the Instituto de Salud Carlos III (ISCIII) and cofinanced by the Fondo Social Europeo Plus (FSE+). Dr. Hidalgo‐Mazzei´s research is supported by a Juan Rodés JR18/00021 to DH granted by the ISCIII. Dr. Vieta and Dr. Radua thank the support of the Spanish Ministry of Science and Innovation (PI15/00283, PI18/00805, PI19/00394, CPII19/00009) integrated into the Plan Nacional de I+D+I and co‐financed by the Instituto de Salud Carlos III (ISCIII)‐Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the ISCIII; the CIBER of Mental Health (CIBERSAM); the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. Dr Passos’ research is supported by National Council for Scientific and Technological Development (CNPq) and by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil.
- bipolar disorder, efficacy, engagement, smartphone interventions, task force
Research areas
ID: 327676297