Chan Eric C, Sun Yuting, Aitchison Katherine J, Sivapalan Sudhakar
Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.
JMIR Form Res. 2021 Jan 8;5(1):e13770. doi: 10.2196/13770.
Bipolar disorder is a chronic, progressive illness characterized by recurrent episodes of mania and depression. Self-report scales have historically played a significant role in the monitoring of bipolar symptoms. However, these tools rely on episodic memory, which can be unreliable and do not allow the clinician to monitor brief episodic symptoms or the course of symptoms over shorter periods of time. Mobile app-based questionnaires have been suggested as a tool to improve monitoring of patients with bipolar disorder.
This paper aims to determine the feasibility and validity of mobile app-based self-report questionnaires.
We performed a systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, PsycInfo, Web of Science, Ovid MEDLINE, and EMBASE databases were searched for papers published in English that assessed adherence to and the validity of mobile app-based self-report questionnaires. Relevant studies published from database creation to May 22, 2020, were identified, and results examining the validity of and rates of adherence to app-based self-report questionnaires are reported.
A total of 13 records were identified for inclusion in this review. Of these studies, 4 assessed the concurrent validity of mobile app-based self-report tools, with the majority of findings indicating significant associations between data collected using these tools and the Young Mania Rating Scale, Hamilton Depression Rating Scale-17, or Montgomery-Åsberg Depression Rating Scale (P<.001 to P=.24). Three studies comparing the variability or range of symptoms between patients with bipolar disorder and healthy controls suggested that these data are capable of differentiating between known groups. Two studies demonstrated statistically significant associations between data collected via mobile app-based self-report tools and instruments assessing other clinically important factors. Adherence rates varied across the studies examined. However, good adherence rates (>70%) were observed in all but 1 study using a once-daily assessment. There was a wide range of adherence rates observed in studies using twice-daily assessments (42%-95%).
These findings suggest that mobile app-based self-report tools are valid in the assessment of symptoms of mania and depression in euthymic patients with bipolar disorder. Data collected using these tools appear to differ between patients with bipolar disorder and healthy controls and are significantly associated with other clinically important measures. It is unclear at this time whether these tools can be used to detect acute episodes of mania or depression in patients with bipolar disorder. Adherence data indicate that patients with bipolar disorder show good adherence to self-report assessments administered daily for the duration of the study periods evaluated.
双相情感障碍是一种慢性进行性疾病，其特征为躁狂和抑郁反复发作。自我报告量表在双相情感障碍症状监测中一直发挥着重要作用。然而，这些工具依赖情景记忆，而情景记忆可能不可靠，并且不允许临床医生监测短暂的情景症状或较短时间内的症状过程。基于移动应用程序的问卷已被建议作为改善双相情感障碍患者监测的一种工具。
本文旨在确定基于移动应用程序的自我报告问卷的可行性和有效性。
我们根据PRISMA（系统评价和Meta分析的首选报告项目）指南对文献进行了系统评价。在PubMed、PsycInfo、科学网、Ovid MEDLINE和EMBASE数据库中检索以英文发表的评估基于移动应用程序的自我报告问卷的依从性和有效性的论文。确定了从数据库创建到2020年5月22日发表的相关研究，并报告了检验基于应用程序的自我报告问卷的有效性和依从率的结果。
共确定13条记录纳入本综述。在这些研究中，4项评估了基于移动应用程序的自我报告工具的同时效度，大多数研究结果表明，使用这些工具收集的数据与杨氏躁狂评定量表、汉密尔顿抑郁评定量表-17或蒙哥马利-阿斯伯格抑郁评定量表之间存在显著关联（P<0.001至P=0.24）。3项比较双相情感障碍患者与健康对照者症状变异性或范围的研究表明，这些数据能够区分已知组。2项研究表明，通过基于移动应用程序的自我报告工具收集的数据与评估其他临床重要因素的工具之间存在统计学上的显著关联。在所研究的各项研究中，依从率各不相同。然而，除1项采用每日一次评估的研究外，所有研究的依从率均良好（>70%）。在采用每日两次评估的研究中，观察到的依从率范围很广（42%-95%）。
这些发现表明，基于移动应用程序的自我报告工具在评估双相情感障碍心境正常患者的躁狂和抑郁症状方面是有效的。使用这些工具收集的数据在双相情感障碍患者和健康对照者之间似乎有所不同，并且与其他临床重要指标显著相关。目前尚不清楚这些工具是否可用于检测双相情感障碍患者的躁狂或抑郁急性发作。依从性数据表明，双相情感障碍患者在评估所研究的整个时间段内对每日进行的自我报告评估表现出良好的依从性。
