June 25, 2019
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Digital phenotyping has potential in psychiatry

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Image of John Torous
John Torous

Digital phenotyping — a method of collecting and synthesizing data from people’s experiences via smartphones or wearable technology — has the potential to help clinicians monitor and treat patients with psychiatric disorders, according to a CME article published in Psychiatric Annals.

Smartphones can be used to record and quantify moment-by-moment changes at the person-level unobtrusively without interactions with clinicians, which offers a lot of new data on exposures experienced outside of the clinic or hospital setting, John Torous, MD, director of the division of digital psychiatry at Beth Israel Deaconess Medical Center, Harvard Medical School, and Healio Psychiatry Peer Perspective Board member, and colleagues explained.

Prior evidence has demonstrated the potential of digital phenotyping in classifying mood states on the basis of activity patterns; quantifying movement, sleep, social networks and cognition; and possibly anticipating and preventing relapses of behavioral conditions, according to the researchers.

“The application of digital phenotyping is probably most relevant to today’s busy psychiatrist in its potential to streamline the error-prone process of initiating and maintaining patients on successful therapeutic strategies,” they wrote. “Once a treatment has been started, phenotyping is likely to offer tremendous potential — beyond mere nosological considerations — to address numerous pragmatic considerations for how to initiate and maintain a patient safely on a treatment regimen that could include pharmacological or behavioral care.”

Torous and colleagues wrote that there are not many clear, reliable prognostic signs that appear at the outset of treatment; therefore, psychiatrists have to wait for their patient to report any unintended adverse effects of a possible treatment to decide whether it may need more time or the dosage should change or they should try something else.

“Because digital phenotyping is likely to enable strategies to sense and synthesize this information with minimal patient or provider burden, future psychiatrists are likely to employ digital therapeutic management strategies that look different from the bread-and-butter clinical psychiatry practiced today,” they explained.

However, along with technical challenges that require further research, challenges — like those involving gaining the trust of patients and providers — remain.

Torous and colleagues noted that the privacy of patient’s data as well as patient safety in using new digital tools like smartphone apps and wearables are areas of concern and prior study has shown that many popular apps for depression and smoking cessation may transmit data without properly disclosing this to users. In addition, there’s a need to better understand patient engagement and make sure that the intended users are represented in the research and development process.

“Although digital phenotyping and associated intervention strategies hold great promise to facilitate real-time monitoring and treatment of patients, it will be critical for research to continue to evaluate the utility of these efforts through open, transparent development among a diverse community of stakeholders,” the researchers concluded. – by Savannah Demko

Disclosure: Torous reports research support from Otsuka Pharmaceuticals. Please see the study for all other authors’ relevant financial disclosures.