Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany.
Department of Psychology, Ludwig Maximilian University of Munich, Munich, Germany.
J Med Internet Res. 2024 Nov 1;26:e51875. doi: 10.2196/51875.
The objective, unobtrusively collected GPS features (eg, homestay and distance) from everyday devices like smartphones may offer a promising augmentation to current assessment tools for depression. However, to date, there is no systematic and meta-analytical evidence on the associations between GPS features and depression.
This study aimed to investigate the between-person and within-person correlations between GPS mobility and activity features and depressive symptoms, and to critically review the quality and potential publication bias in the field.
We searched MEDLINE, PsycINFO, Embase, CENTRAL, ACM, IEEE Xplore, PubMed, and Web of Science to identify eligible articles focusing on the correlations between GPS features and depression from December 6, 2022, to March 24, 2023. Inclusion and exclusion criteria were applied in a 2-stage inclusion process conducted by 2 independent reviewers (YT and JK). To be eligible, studies needed to report correlations between wearable-based GPS variables (eg, total distance) and depression symptoms measured with a validated questionnaire. Studies with underage persons and other mental health disorders were excluded. Between- and within-person correlations were analyzed using random effects models. Study quality was determined by comparing studies against the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) guidelines. Publication bias was investigated using Egger test and funnel plots.
A total of k=19 studies involving N=2930 participants were included in the analysis. The mean age was 38.42 (SD 18.96) years with 59.64% (SD 22.99%) of participants being female. Significant between-person correlations between GPS features and depression were identified: distance (r=-0.25, 95% CI -0.29 to -0.21), normalized entropy (r-0.17, 95% CI -0.29 to -0.04), location variance (r-0.17, 95% CI -0.26 to -0.04), entropy (r=-0.13, 95% CI -0.23 to -0.04), number of clusters (r=-0.11, 95% CI -0.18 to -0.03), and homestay (r=0.10, 95% CI 0.00 to 0.19). Studies reporting within-correlations (k=3) were too heterogeneous to conduct meta-analysis. A deficiency in study quality and research standards was identified: all studies followed exploratory observational designs, but no study referenced or fully adhered to the international guidelines for reporting observational studies (STROBE). A total of 79% (k=15) of the studies were underpowered to detect a small correlation (r=.20). Results showed evidence for potential publication bias.
Our results provide meta-analytical evidence for between-person correlations of GPS mobility and activity features and depression. Hence, depression diagnostics may benefit from adding GPS mobility and activity features as an integral part of future assessment and expert tools. However, confirmatory studies for between-person correlations and further research on within-person correlations are needed. In addition, the methodological quality of the evidence needs to improve.
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从智能手机等日常设备中客观、非侵入性地收集 GPS 特征（例如，常住地和距离），可能为当前的抑郁评估工具提供有前景的补充。然而，迄今为止，尚无关于 GPS 特征与抑郁之间的关联的系统和荟萃分析证据。
本研究旨在调查 GPS 移动性和活动特征与抑郁症状之间的个体间和个体内相关性，并批判性地审查该领域的研究质量和潜在的发表偏倚。
我们从 2022 年 12 月 6 日至 2023 年 3 月 24 日，通过 MEDLINE、PsycINFO、Embase、CENTRAL、ACM、IEEE Xplore、PubMed 和 Web of Science 搜索了符合条件的文章，这些文章重点关注了基于可穿戴设备的 GPS 变量（例如，总距离）与抑郁症状之间的相关性，并使用经过验证的问卷进行了测量。纳入和排除标准在由 2 名独立评审员（YT 和 JK）进行的 2 阶段纳入过程中应用。有资格的研究需要报告与抑郁症状相关的可穿戴式 GPS 变量（例如，总距离）与经过验证的问卷之间的相关性。研究对象为未成年人和其他精神健康障碍的研究被排除在外。使用随机效应模型分析个体间和个体内相关性。通过比较研究与 STROBE（强化观察性研究的报告）指南，确定了研究质量。使用 Egger 检验和漏斗图调查了发表偏倚。
共纳入了 k=19 项研究，涉及 N=2930 名参与者。参与者的平均年龄为 38.42（SD 18.96）岁，其中 59.64%（SD 22.99%）为女性。确定了 GPS 特征与抑郁之间存在显著的个体间相关性：距离（r=-0.25，95%CI -0.29 至 -0.21）、归一化熵（r=-0.17，95%CI -0.29 至 -0.04）、位置方差（r=-0.17，95%CI -0.26 至 -0.04）、熵（r=-0.13，95%CI -0.23 至 -0.04）、聚类数（r=-0.11，95%CI -0.18 至 -0.03）和常住地（r=0.10，95%CI 0.00 至 0.19）。报告个体内相关性的研究（k=3）差异太大，无法进行荟萃分析。确定了研究质量和研究标准的不足：所有研究均采用探索性观察设计，但没有研究参考或完全遵守国际观察性研究报告指南（STROBE）。共有 79%（k=15）的研究在检测小相关性（r=.20）时功率不足。结果表明存在潜在的发表偏倚。
我们的结果为 GPS 移动性和活动特征与抑郁之间的个体间相关性提供了荟萃分析证据。因此，在未来的评估和专家工具中添加 GPS 移动性和活动特征可能会使抑郁诊断受益。然而，需要进行个体间相关性的验证性研究和个体内相关性的进一步研究。此外，证据的方法学质量需要提高。
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