Validation of an mHealth App for Depression Screening and Monitoring (Psychologist in a Pocket): Correlational Study and Concurrence Analysis

Abstract

BackgroundMobile health (mHealth) is a fast-growing professional sector. As of 2016, there were more than 259,000 mHealth apps available internationally. Although mHealth apps are growing in acceptance, relatively little attention and limited efforts have been invested to establish their scientific integrity through statistical validation. This paper presents the external validation of Psychologist in a Pocket (PiaP), an Android-based mental mHealth app which supports traditional approaches in depression screening and monitoring through the analysis of electronic text inputs in communication apps.ObjectiveThe main objectives of the study were (1) to externally validate the construct of the depression lexicon of PiaP with standardized psychological paper-and-pencil tools and (2) to determine the comparability of PiaP, a new depression measure, with a psychological gold standard in identifying depression.MethodsCollege participants downloaded PiaP for a 2-week administration. Afterward, they were asked to complete 4 psychological depression instruments. Furthermore, 1-week and 2-week PiaP total scores (PTS) were correlated with (1) Beck Depression Index (BDI)-II and Center for Epidemiological Studies–Depression (CES-D) Scale for congruent construct validation, (2) Affect Balance Scale (ABS)–Negative Affect for convergent construct validation, and (3) Satisfaction With Life Scale (SWLS) and ABS–Positive Affect for divergent construct validation. In addition, concordance analysis between PiaP and BDI-II was performed.ResultsOn the basis of the Pearson product-moment correlation, significant positive correlations exist between (1) 1-week PTS and CES-D Scale, (2) 2-week PTS and BDI-II, and (3) PiaP 2-week PTS and SWLS. Concordance analysis (Bland-Altman plot and analysis) suggested that PiaP’s approach to depression screening is comparable with the gold standard (BDI-II).ConclusionsThe evaluation of mental health has historically relied on subjective measurements. With the integration of novel approaches using mobile technology (and, by extension, mHealth apps) in mental health care, the validation process becomes more compelling to ensure their accuracy and credibility. This study suggests that PiaP’s approach to depression screening by analyzing electronic data is comparable with traditional and well-established depression instruments and can be used to augment the process of measuring depression symptoms.

Patient and physician perspectives of a smartphone application for depression: a qualitative study

“…In line with our results, several studies pointed out the possible interest of apps for depression screening in the general population, showing that a large number of people from different countries were searching for, and willing to use, that kind of tool [40]. Additionally, several apps using text analysis have shown their ability to improve the immediate detection of depressive symptoms [41,42]. Finally, several studies highlighted the fact that depression screening apps could motivate some users to discuss the obtained results of the tests with healthcare professionals for further diagnosis and management [43,44].…”

Challenges to the Emergence of Telerehabilitation in a Developing Country: A Systematic Review

“…Twelve out of 25 studies engaged patients from remote areas to access healthcare services or information in teleconsultation, teletherapy, telementoring, or telemonitoring. Three studies involved patients with general medical conditions ( 30 , 33 , 37 ), while other studies involved patients with chronic diseases ( 18 , 29 ), mental health issues ( 17 , 26 ), orthopedic problems ( 20 , 28 ), neurologic conditions ( 16 ), communication disorders ( 19 ), and cardiac disease ( 36 ).…”

“…There was one local study that involved physiatrists, physical therapists, occupational therapists, psychologists, and rehabilitation nurses in multi-disciplinary telerehabilitation sessions with a remote community (20). Another study involved speech-language pathologists (19), while two studies involved psychologists (17,26). Telementoring meant that a remote specialist gave expert advice to a rural physician or healthcare worker co-located with a patient (20,30,33,37).…”

Patients’ adherence to smartphone apps in the management of bipolar disorder: a systematic review

“…Furthermore, the better adherence to apps in research protocols compare to real world highlights the essential role of face-to-face meetings in mental healthcare (Baumel et al 2019 ; Ebert and Baumeister 2017 ). If they are able to facilitate access to psychiatric care to the largest number of individuals (BinDhim et al 2015 ; Ramos et al 2019 ; Cheng et al 2016 ), self-help apps should be restricted to screening tools, and their main purpose should be to guide patients toward medical care. Therapeutic apps should be fully integrated in therapy and be closely monitored by therapists.…”