The Association Between Home Stay and Symptom Severity in Major Depressive Disorder: Preliminary Findings From a Multicenter Observational Study Using Geolocation Data From Smartphones

RADAR-CNS

doi:10.2196/28095

The Association Between Home Stay and Symptom Severity in Major Depressive Disorder: Preliminary Findings From a Multicenter Observational Study Using Geolocation Data From Smartphones

RADAR-CNS

Research output: Contribution to journal › Article › peer-review

18 Citations (Scopus)

Abstract

BACKGROUND: Most smartphones and wearables are currently equipped with location sensing (using GPS and mobile network information), which enables continuous location tracking of their users. Several studies have reported that various mobility metrics, as well as home stay, that is, the amount of time an individual spends at home in a day, are associated with symptom severity in people with major depressive disorder (MDD). Owing to the use of small and homogeneous cohorts of participants, it is uncertain whether the findings reported in those studies generalize to a broader population of individuals with MDD symptoms. OBJECTIVE: The objective of this study is to examine the relationship between the overall severity of depressive symptoms, as assessed by the 8-item Patient Health Questionnaire, and median daily home stay over the 2 weeks preceding the completion of a questionnaire in individuals with MDD. METHODS: We used questionnaire and geolocation data of 164 participants with MDD collected in the observational Remote Assessment of Disease and Relapse-Major Depressive Disorder study. The participants were recruited from three study sites: King's College London in the United Kingdom (109/164, 66.5%); Vrije Universiteit Medisch Centrum in Amsterdam, the Netherlands (17/164, 10.4%); and Centro de Investigación Biomédica en Red in Barcelona, Spain (38/164, 23.2%). We used a linear regression model and a resampling technique (n=100 draws) to investigate the relationship between home stay and the overall severity of MDD symptoms. Participant age at enrollment, gender, occupational status, and geolocation data quality metrics were included in the model as additional explanatory variables. The 95% 2-sided CIs were used to evaluate the significance of model variables. RESULTS: Participant age and severity of MDD symptoms were found to be significantly related to home stay, with older (95% CI 0.161-0.325) and more severely affected individuals (95% CI 0.015-0.184) spending more time at home. The association between home stay and symptoms severity appeared to be stronger on weekdays (95% CI 0.023-0.178, median 0.098; home stay: 25th-75th percentiles 17.8-22.8, median 20.9 hours a day) than on weekends (95% CI -0.079 to 0.149, median 0.052; home stay: 25th-75th percentiles 19.7-23.5, median 22.3 hours a day). Furthermore, we found a significant modulation of home stay by occupational status, with employment reducing home stay (employed participants: 25th-75th percentiles 16.1-22.1, median 19.7 hours a day; unemployed participants: 25th-75th percentiles 20.4-23.5, median 22.6 hours a day). CONCLUSIONS: Our findings suggest that home stay is associated with symptom severity in MDD and demonstrate the importance of accounting for confounding factors in future studies. In addition, they illustrate that passive sensing of individuals with depression is feasible and could provide clinically relevant information to monitor the course of illness in patients with MDD.

Original language	English
Article number	e28095
Pages (from-to)	e28095
Journal	JMIR mHealth and uHealth
Volume	10
Issue number	1
Early online date	28 Jan 2022
DOIs	https://doi.org/10.2196/28095
Publication status	Published - 28 Jan 2022

Keywords

GPS
home stay
major depressive disorder
mobile phone
PHQ-8
smartphone

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10.2196/28095

Cite this

@article{3aee8be7ff414de3bc07ed82d24da140,

title = "The Association Between Home Stay and Symptom Severity in Major Depressive Disorder: Preliminary Findings From a Multicenter Observational Study Using Geolocation Data From Smartphones",

abstract = "BACKGROUND: Most smartphones and wearables are currently equipped with location sensing (using GPS and mobile network information), which enables continuous location tracking of their users. Several studies have reported that various mobility metrics, as well as home stay, that is, the amount of time an individual spends at home in a day, are associated with symptom severity in people with major depressive disorder (MDD). Owing to the use of small and homogeneous cohorts of participants, it is uncertain whether the findings reported in those studies generalize to a broader population of individuals with MDD symptoms. OBJECTIVE: The objective of this study is to examine the relationship between the overall severity of depressive symptoms, as assessed by the 8-item Patient Health Questionnaire, and median daily home stay over the 2 weeks preceding the completion of a questionnaire in individuals with MDD. METHODS: We used questionnaire and geolocation data of 164 participants with MDD collected in the observational Remote Assessment of Disease and Relapse-Major Depressive Disorder study. The participants were recruited from three study sites: King's College London in the United Kingdom (109/164, 66.5%); Vrije Universiteit Medisch Centrum in Amsterdam, the Netherlands (17/164, 10.4%); and Centro de Investigaci{\'o}n Biom{\'e}dica en Red in Barcelona, Spain (38/164, 23.2%). We used a linear regression model and a resampling technique (n=100 draws) to investigate the relationship between home stay and the overall severity of MDD symptoms. Participant age at enrollment, gender, occupational status, and geolocation data quality metrics were included in the model as additional explanatory variables. The 95% 2-sided CIs were used to evaluate the significance of model variables. RESULTS: Participant age and severity of MDD symptoms were found to be significantly related to home stay, with older (95% CI 0.161-0.325) and more severely affected individuals (95% CI 0.015-0.184) spending more time at home. The association between home stay and symptoms severity appeared to be stronger on weekdays (95% CI 0.023-0.178, median 0.098; home stay: 25th-75th percentiles 17.8-22.8, median 20.9 hours a day) than on weekends (95% CI -0.079 to 0.149, median 0.052; home stay: 25th-75th percentiles 19.7-23.5, median 22.3 hours a day). Furthermore, we found a significant modulation of home stay by occupational status, with employment reducing home stay (employed participants: 25th-75th percentiles 16.1-22.1, median 19.7 hours a day; unemployed participants: 25th-75th percentiles 20.4-23.5, median 22.6 hours a day). CONCLUSIONS: Our findings suggest that home stay is associated with symptom severity in MDD and demonstrate the importance of accounting for confounding factors in future studies. In addition, they illustrate that passive sensing of individuals with depression is feasible and could provide clinically relevant information to monitor the course of illness in patients with MDD.",

keywords = "GPS, home stay, major depressive disorder, mobile phone, PHQ-8, smartphone",

author = "RADAR-CNS and Petroula Laiou and Kaliukhovich, {Dzmitry A.} and Folarin, {Amos A.} and Yatharth Ranjan and Zulqarnain Rashid and Pauline Conde and Callum Stewart and Shaoxiong Sun and Yuezhou Zhang and Faith Matcham and Alina Ivan and Grace Lavelle and Sara Siddi and Femke Lamers and Penninx, {Brenda Wjh} and Haro, {Josep Maria} and Peter Annas and Nicholas Cummins and Srinivasan Vairavan and Manyakov, {Nikolay V.} and Narayan, {Vaibhav A.} and Dobson, {Richard Jb} and Matthew Hotopf",

note = "Funding Information: Participant recruitment in Amsterdam was partially accomplished through Hersenonderzoek.nl, a Dutch online registry that facilitates participant recruitment for neuroscience studies [32]. Hersenonderzoek.nl is funded by ZonMw-Memorabel (project number 73305095003), a project in the context of the Dutch Deltaplan Dementie, Gieskes-Strijbis Foundation, the Alzheimer's Society in the Netherlands and Brain Foundation Netherlands. Funding Information: The Remote Assessment of Disease and Relapse–Central Nervous System project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement number 115902. This Joint Undertaking receives support from the European Union{\textquoteright}s Horizon 2020 research and innovation programme and European Federation of Pharmaceutical Industries and Associations [31]. This communication reflects the views of the Remote Assessment of Disease and Relapse–Central Nervous System consortium and neither Innovative Medicines Initiative nor the European Union and European Federation of Pharmaceutical Industries and Associations are liable for any use that may be made of the information contained herein. The funding body have not been involved in the design of the study, the collection or analysis of data, or the interpretation of data. Participant recruitment in Amsterdam was partially accomplished through Hersenonderzoek.nl, a Dutch online registry that facilitates participant recruitment for neuroscience studies [32]. Hersenonderzoek.nl is funded by ZonMw-Memorabel (project number 73305095003), a project in the context of the Dutch Deltaplan Dementie, Gieskes-Strijbis Foundation, the Alzheimer's Society in the Netherlands and Brain Foundation Netherlands. Participants in Spain were recruited through the following institutions: Parc Sanitari Sant Joan de D{\'e}u network of mental health services (Barcelona); Institut Catal{\`a} de la Salut primary care services (Barcelona); Institut Pere Mata-Mental Health Care (Tarrassa); Hospital Cl{\'i}nico San Carlos (Madrid). This paper represents independent research part funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley National Health Service (NHS) Foundation Trust and King{\textquoteright}s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. We thank all the members of the Remote Assessment of Disease and Relapse–Central Nervous System patient advisory board for their contribution to the device selection procedures, and their invaluable advice throughout the study protocol design. This research was reviewed by a team with experience of mental health problems and their carers who have been specially trained to advise on research proposals and documentation through the Feasibility and Acceptability Support Team for Researchers: a free, confidential service in England provided by the National Institute for Health Research Maudsley Biomedical Research Centre via King{\textquoteright}s College London and South London and Maudsley NHS Foundation Trust. We thank all Genetic Links to Anxiety and Depression Study volunteers for their participation, and gratefully acknowledge the NIHR BioResource, NIHR BioResource centres, NHS Trusts and staff for their contribution. We also acknowledge NIHR BRC, King{\textquoteright}s College London, South London and Maudsley NHS Trust and King's Health Partners. We thank the National Institute for Health Research, NHS Blood and Transplant, and Health Data Research UK as part of the Digital Innovation Hub Programme. Funding Information: DAK and NVM are employees of the Janssen Pharmaceutica NV and may hold company equity. SV and VAN are employees of Janssen Research and Development, LLC, and may hold company equity. PA is an employee of H. Lundbeck A/S and may hold company equity. MH declares research grants and in-kind contributions from Janssen, Biogen, UCB, MSD, and H. Lundbeck A/S through the Remote Assessment of Disease and Relapse–Central Nervous System consortium. Funding Information: The Remote Assessment of Disease and Relapse–Central Nervous System project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement number 115902. This Joint Undertaking receives support from the European Union{\textquoteright}s Horizon 2020 research and innovation programme and European Federation of Pharmaceutical Industries and Associations [31]. This communication reflects the views of the Remote Assessment of Disease and Relapse–Central Nervous System consortium and neither Innovative Medicines Initiative nor the European Union and European Federation of Pharmaceutical Industries and Associations are liable for any use that may be made of the information contained herein. The funding body have not been involved in the design of the study, the collection or analysis of data, or the interpretation of data. Funding Information: This paper represents independent research part funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley National Health Service (NHS) Foundation Trust and King{\textquoteright}s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Publisher Copyright: {\textcopyright}Petroula Laiou, Dzmitry A Kaliukhovich, Amos A Folarin, Yatharth Ranjan, Zulqarnain Rashid, Pauline Conde, Callum Stewart, Shaoxiong Sun, Yuezhou Zhang, Faith Matcham, Alina Ivan, Grace Lavelle, Sara Siddi, Femke Lamers, Brenda WJH Penninx, Josep Maria Haro, Peter Annas, Nicholas Cummins, Srinivasan Vairavan, Nikolay V Manyakov, Vaibhav A Narayan, Richard JB Dobson, Matthew Hotopf, RADAR-CNS.",

year = "2022",

month = jan,

day = "28",

doi = "10.2196/28095",

language = "English",

volume = "10",

pages = "e28095",

journal = "JMIR mHealth and uHealth",

issn = "2291-5222",

publisher = "JMIR Publications",

number = "1",

}

TY - JOUR

T1 - The Association Between Home Stay and Symptom Severity in Major Depressive Disorder

T2 - Preliminary Findings From a Multicenter Observational Study Using Geolocation Data From Smartphones

AU - RADAR-CNS

AU - Laiou, Petroula

AU - Kaliukhovich, Dzmitry A.

AU - Folarin, Amos A.

AU - Ranjan, Yatharth

AU - Rashid, Zulqarnain

AU - Conde, Pauline

AU - Stewart, Callum

AU - Sun, Shaoxiong

AU - Zhang, Yuezhou

AU - Matcham, Faith

AU - Ivan, Alina

AU - Lavelle, Grace

AU - Siddi, Sara

AU - Lamers, Femke

AU - Penninx, Brenda Wjh

AU - Haro, Josep Maria

AU - Annas, Peter

AU - Cummins, Nicholas

AU - Vairavan, Srinivasan

AU - Manyakov, Nikolay V.

AU - Narayan, Vaibhav A.

AU - Dobson, Richard Jb

AU - Hotopf, Matthew

N1 - Funding Information: Participant recruitment in Amsterdam was partially accomplished through Hersenonderzoek.nl, a Dutch online registry that facilitates participant recruitment for neuroscience studies [32]. Hersenonderzoek.nl is funded by ZonMw-Memorabel (project number 73305095003), a project in the context of the Dutch Deltaplan Dementie, Gieskes-Strijbis Foundation, the Alzheimer's Society in the Netherlands and Brain Foundation Netherlands. Funding Information: The Remote Assessment of Disease and Relapse–Central Nervous System project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement number 115902. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and European Federation of Pharmaceutical Industries and Associations [31]. This communication reflects the views of the Remote Assessment of Disease and Relapse–Central Nervous System consortium and neither Innovative Medicines Initiative nor the European Union and European Federation of Pharmaceutical Industries and Associations are liable for any use that may be made of the information contained herein. The funding body have not been involved in the design of the study, the collection or analysis of data, or the interpretation of data. Participant recruitment in Amsterdam was partially accomplished through Hersenonderzoek.nl, a Dutch online registry that facilitates participant recruitment for neuroscience studies [32]. Hersenonderzoek.nl is funded by ZonMw-Memorabel (project number 73305095003), a project in the context of the Dutch Deltaplan Dementie, Gieskes-Strijbis Foundation, the Alzheimer's Society in the Netherlands and Brain Foundation Netherlands. Participants in Spain were recruited through the following institutions: Parc Sanitari Sant Joan de Déu network of mental health services (Barcelona); Institut Català de la Salut primary care services (Barcelona); Institut Pere Mata-Mental Health Care (Tarrassa); Hospital Clínico San Carlos (Madrid). This paper represents independent research part funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley National Health Service (NHS) Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. We thank all the members of the Remote Assessment of Disease and Relapse–Central Nervous System patient advisory board for their contribution to the device selection procedures, and their invaluable advice throughout the study protocol design. This research was reviewed by a team with experience of mental health problems and their carers who have been specially trained to advise on research proposals and documentation through the Feasibility and Acceptability Support Team for Researchers: a free, confidential service in England provided by the National Institute for Health Research Maudsley Biomedical Research Centre via King’s College London and South London and Maudsley NHS Foundation Trust. We thank all Genetic Links to Anxiety and Depression Study volunteers for their participation, and gratefully acknowledge the NIHR BioResource, NIHR BioResource centres, NHS Trusts and staff for their contribution. We also acknowledge NIHR BRC, King’s College London, South London and Maudsley NHS Trust and King's Health Partners. We thank the National Institute for Health Research, NHS Blood and Transplant, and Health Data Research UK as part of the Digital Innovation Hub Programme. Funding Information: DAK and NVM are employees of the Janssen Pharmaceutica NV and may hold company equity. SV and VAN are employees of Janssen Research and Development, LLC, and may hold company equity. PA is an employee of H. Lundbeck A/S and may hold company equity. MH declares research grants and in-kind contributions from Janssen, Biogen, UCB, MSD, and H. Lundbeck A/S through the Remote Assessment of Disease and Relapse–Central Nervous System consortium. Funding Information: The Remote Assessment of Disease and Relapse–Central Nervous System project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement number 115902. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and European Federation of Pharmaceutical Industries and Associations [31]. This communication reflects the views of the Remote Assessment of Disease and Relapse–Central Nervous System consortium and neither Innovative Medicines Initiative nor the European Union and European Federation of Pharmaceutical Industries and Associations are liable for any use that may be made of the information contained herein. The funding body have not been involved in the design of the study, the collection or analysis of data, or the interpretation of data. Funding Information: This paper represents independent research part funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley National Health Service (NHS) Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Publisher Copyright: ©Petroula Laiou, Dzmitry A Kaliukhovich, Amos A Folarin, Yatharth Ranjan, Zulqarnain Rashid, Pauline Conde, Callum Stewart, Shaoxiong Sun, Yuezhou Zhang, Faith Matcham, Alina Ivan, Grace Lavelle, Sara Siddi, Femke Lamers, Brenda WJH Penninx, Josep Maria Haro, Peter Annas, Nicholas Cummins, Srinivasan Vairavan, Nikolay V Manyakov, Vaibhav A Narayan, Richard JB Dobson, Matthew Hotopf, RADAR-CNS.

PY - 2022/1/28

Y1 - 2022/1/28

N2 - BACKGROUND: Most smartphones and wearables are currently equipped with location sensing (using GPS and mobile network information), which enables continuous location tracking of their users. Several studies have reported that various mobility metrics, as well as home stay, that is, the amount of time an individual spends at home in a day, are associated with symptom severity in people with major depressive disorder (MDD). Owing to the use of small and homogeneous cohorts of participants, it is uncertain whether the findings reported in those studies generalize to a broader population of individuals with MDD symptoms. OBJECTIVE: The objective of this study is to examine the relationship between the overall severity of depressive symptoms, as assessed by the 8-item Patient Health Questionnaire, and median daily home stay over the 2 weeks preceding the completion of a questionnaire in individuals with MDD. METHODS: We used questionnaire and geolocation data of 164 participants with MDD collected in the observational Remote Assessment of Disease and Relapse-Major Depressive Disorder study. The participants were recruited from three study sites: King's College London in the United Kingdom (109/164, 66.5%); Vrije Universiteit Medisch Centrum in Amsterdam, the Netherlands (17/164, 10.4%); and Centro de Investigación Biomédica en Red in Barcelona, Spain (38/164, 23.2%). We used a linear regression model and a resampling technique (n=100 draws) to investigate the relationship between home stay and the overall severity of MDD symptoms. Participant age at enrollment, gender, occupational status, and geolocation data quality metrics were included in the model as additional explanatory variables. The 95% 2-sided CIs were used to evaluate the significance of model variables. RESULTS: Participant age and severity of MDD symptoms were found to be significantly related to home stay, with older (95% CI 0.161-0.325) and more severely affected individuals (95% CI 0.015-0.184) spending more time at home. The association between home stay and symptoms severity appeared to be stronger on weekdays (95% CI 0.023-0.178, median 0.098; home stay: 25th-75th percentiles 17.8-22.8, median 20.9 hours a day) than on weekends (95% CI -0.079 to 0.149, median 0.052; home stay: 25th-75th percentiles 19.7-23.5, median 22.3 hours a day). Furthermore, we found a significant modulation of home stay by occupational status, with employment reducing home stay (employed participants: 25th-75th percentiles 16.1-22.1, median 19.7 hours a day; unemployed participants: 25th-75th percentiles 20.4-23.5, median 22.6 hours a day). CONCLUSIONS: Our findings suggest that home stay is associated with symptom severity in MDD and demonstrate the importance of accounting for confounding factors in future studies. In addition, they illustrate that passive sensing of individuals with depression is feasible and could provide clinically relevant information to monitor the course of illness in patients with MDD.

AB - BACKGROUND: Most smartphones and wearables are currently equipped with location sensing (using GPS and mobile network information), which enables continuous location tracking of their users. Several studies have reported that various mobility metrics, as well as home stay, that is, the amount of time an individual spends at home in a day, are associated with symptom severity in people with major depressive disorder (MDD). Owing to the use of small and homogeneous cohorts of participants, it is uncertain whether the findings reported in those studies generalize to a broader population of individuals with MDD symptoms. OBJECTIVE: The objective of this study is to examine the relationship between the overall severity of depressive symptoms, as assessed by the 8-item Patient Health Questionnaire, and median daily home stay over the 2 weeks preceding the completion of a questionnaire in individuals with MDD. METHODS: We used questionnaire and geolocation data of 164 participants with MDD collected in the observational Remote Assessment of Disease and Relapse-Major Depressive Disorder study. The participants were recruited from three study sites: King's College London in the United Kingdom (109/164, 66.5%); Vrije Universiteit Medisch Centrum in Amsterdam, the Netherlands (17/164, 10.4%); and Centro de Investigación Biomédica en Red in Barcelona, Spain (38/164, 23.2%). We used a linear regression model and a resampling technique (n=100 draws) to investigate the relationship between home stay and the overall severity of MDD symptoms. Participant age at enrollment, gender, occupational status, and geolocation data quality metrics were included in the model as additional explanatory variables. The 95% 2-sided CIs were used to evaluate the significance of model variables. RESULTS: Participant age and severity of MDD symptoms were found to be significantly related to home stay, with older (95% CI 0.161-0.325) and more severely affected individuals (95% CI 0.015-0.184) spending more time at home. The association between home stay and symptoms severity appeared to be stronger on weekdays (95% CI 0.023-0.178, median 0.098; home stay: 25th-75th percentiles 17.8-22.8, median 20.9 hours a day) than on weekends (95% CI -0.079 to 0.149, median 0.052; home stay: 25th-75th percentiles 19.7-23.5, median 22.3 hours a day). Furthermore, we found a significant modulation of home stay by occupational status, with employment reducing home stay (employed participants: 25th-75th percentiles 16.1-22.1, median 19.7 hours a day; unemployed participants: 25th-75th percentiles 20.4-23.5, median 22.6 hours a day). CONCLUSIONS: Our findings suggest that home stay is associated with symptom severity in MDD and demonstrate the importance of accounting for confounding factors in future studies. In addition, they illustrate that passive sensing of individuals with depression is feasible and could provide clinically relevant information to monitor the course of illness in patients with MDD.

KW - GPS

KW - home stay

KW - major depressive disorder

KW - mobile phone

KW - PHQ-8

KW - smartphone

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The Association Between Home Stay and Symptom Severity in Major Depressive Disorder: Preliminary Findings From a Multicenter Observational Study Using Geolocation Data From Smartphones

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