Background: Smartphone-based symptom monitoring has gained increased attention in psychiatric research as a cost-efficient tool for prospective and ecologically valid assessments based on participants’ self-reports. However, a meaningful interpretation of smartphone-based assessments requires knowledge about their psychometric properties, especially their validity. Objective: The goal of this study is to systematically investigate the validity of smartphone-administered assessments of self-reported affective symptoms using the Remote Monitoring Application in Psychiatry (ReMAP). Methods: The ReMAP app was distributed to 173 adult participants of ongoing, longitudinal psychiatric phenotyping studies, including healthy control participants, as well as patients with affective disorders and anxiety disorders; the mean age of the sample was 30.14 years (SD 11.92). The Beck Depression Inventory (BDI) and single-item mood and sleep information were assessed via the ReMAP app and validated with non–smartphone-based BDI scores and clinician-rated depression severity using the Hamilton Depression Rating Scale (HDRS). Results: We found overall high comparability between smartphone-based and non–smartphone-based BDI scores (intraclass correlation coefficient=0.921; P<.001). Smartphone-based BDI scores further correlated with non–smartphone-based HDRS ratings of depression severity in a subsample (r=0.783; P<.001; n=51). Higher agreement between smartphone-based and non–smartphone-based assessments was found among affective disorder patients as compared to healthy controls and anxiety disorder patients. Highly comparable agreement between delivery formats was found across age and gender groups. Similarly, smartphone-based single-item self-ratings of mood correlated with BDI sum scores (r=–0.538; P<.001; n=168), while smartphone-based single-item sleep duration correlated with the sleep item of the BDI (r=–0.310; P<.001; n=166). Conclusions: These findings demonstrate that smartphone-based monitoring of depressive symptoms via the ReMAP app provides valid assessments of depressive symptomatology and, therefore, represents a useful tool for prospective digital phenotyping in affective disorder patients in clinical and research applications.

中文翻译：

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使用智能手机远程监控应用程序基于智能手机的抑郁症症状自我报告（ReMAP）：格式验证研究

背景：基于智能手机的症状监测已在精神病学研究中得到了越来越多的关注，这是一种基于参与者自我报告的经济有效的前瞻性和生态有效评估工具。但是，对基于智能手机的评估进行有意义的解释需要了解其心理测量特性，尤其是其有效性。目的：本研究的目的是使用“精神病学远程监控应用程序”（ReMAP）系统研究智能手机管理的自我报告的情感症状评估的有效性。方法：ReMAP应用程序已分发给正在进行的纵向精神病学表型研究的173名成年参与者，包括健康对照参与者以及患有情感障碍和焦虑症的患者；样本的平均年龄为30.14岁（SD 11.92）。通过ReMAP应用程序评估了贝克抑郁量表（BDI）和单项情绪和睡眠信息，并使用基于汉密尔顿抑郁量表（HDRS）的非智能手机BDI评分和临床医生评估的抑郁严重程度进行了验证。结果：我们发现基于智能手机的BDI评分与基于非智能手机的BDI评分总体上具有较高的可比性（类内相关系数= 0.921；P<.001）。在子样本中，基于智能手机的BDI评分与基于非智能手机的HDRS抑郁症严重程度进一步相关（r = 0.783；P <.001； n = 51）。与健康对照组和焦虑症患者相比，情感障碍患者的基于智能手机的评估与基于非智能手机的评估之间的一致性更高。跨性别和年龄组的交付格式之间的协议具有高度可比性。同样，基于智能手机的单项情绪自我评分与BDI总分相关（r = -0.538；P <.001； n = 168），而基于智能手机的单项睡眠时间与儿童的睡眠项目相关。 BDI（r = -0.310；P <.001； n = 166）。结论：这些发现表明，通过ReMAP应用程序基于智能手机的抑郁症状监测可提供抑郁症状的有效评估，因此，代表了在情感障碍患者临床和研究应用中进行前瞻性数字表型分析的有用工具。