Self-Monitoring and Self-Efficacy Increase with a Smartphone Application: A Technical Approach to Treating Bipolar Disorder?-Study Protocol for a Clinical Validation Trial

Author(s): Frederike T Fellendorf, Carlo Hamm, Martina Platzer, Christian Pendl, Ralph Gruber, Manfred Weiss, Nina Dalkner, Susanne A Bengesser, Armin Birner, Robert Queissner, Rene Pilz, Hans-Peter Kapfhamme

Background: Bipolar disorder (BD) is characterized by mood fluctuations, which are often recognized late by those who are affected. Symptom monitoring via smartphone seems to be an inexpensive and feasible method to detect these fluctuations earlier. The aim of an application (app) for smartphones is to record individual activity patterns (e.g. physical activity, sleep-wake rhythm, digital communication) as characteristic for mood swings in individuals with BD.

Methods: We developed the UP! app for Android smartphones, which collects subjective mood daily and continuous data about movement, exercise, sleep duration and intensity of digital communication via GPS and sensors. This pilot trial will include 24 individuals with BD and 24 healthy controls (HC) without a mental disorder. The main aim of this study is to assess the app’s validity to detect mood fluctuations and illness episodes in comparison to a clinical psychiatric interview, validated questionnaires and a fitness tracker. A second aim is to determine whether changes in activity patterns, measured with the app, can detect early warning symptoms of depressive and/or manic episodes. The third aim is the evaluation of users’ acceptance of the app. The recruitment of participants (planned n=48) is ongoing.

Discussion: Behavior patterns recognition via smartphone could present an innovative, technological tool for the early detection of BD episodes and could be valuable for long-term research.

Registration Details: The trial is approved by the ethics committee of the Medical University Graz, Austria (29-290 ex 16/17). The trial is registered at as NCT03275714.

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