Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management

Abstract

Background Individuals with bipolar disorder (BD) are increasingly turning to smartphone applications (apps) for health information and self-management support. While reviews have raised concerns regarding the effectiveness and safety of publicly available apps for BD, apps surveyed may not reflect what individuals with BD are using. The present study had two aims: first, to characterize the use of health apps to support mood and sleep amongst people with BD, and second, to evaluate the quality, safety and functionality of the most commonly used self-management apps. Methods A web-based survey was conducted to explore which apps people with BD reported using to support self-management of mood and sleep. The characteristics of the most commonly nominated apps were described using a standardized framework, including their privacy policy, clinical foundations, and functionality. Results Respondents (n = 919) were 77.9% female with a mean age of 36.9 years. 41.6% of participants (n = 382) reported using a self-management app to support mood or sleep. 110 unique apps were nominated in relation to mood, and 104 unique apps nominated in relation to sleep; however, most apps were only mentioned once. The nine most frequently nominated apps related to mood and sleep were subject to further evaluation. All reviewed apps offered a privacy policy, however user control over data was limited and the complexity of privacy policies was high. Only one app was developed for BD populations. Half of reviewed apps had published peer-reviewed evidence to support their claims of efficacy, but little research was specific to BD. Conclusion Findings illustrate the potential of smartphone apps to increase the reach of psychosocial interventions amongst people with BD. Apps were largely created by commercial developers and designed for the general population, highlighting a gap in the development and dissemination of evidence-informed apps for BD. There may be risks in using generic health apps for BD self-management; clinicians should enquire about patients’ app use to foster conversations about their particular benefits and limitations.

Digital Tools to Facilitate the Detection and Treatment of Bipolar Disorder: Key Developments and Future Directions

“…Although research-led studies have developed and evaluated mobile apps for BD, the dissemination and uptake of these apps in real-world contexts must be considered to reach the target population and maximize their impact. A recent web-based survey investigating the use of mobile apps to support mood and sleep self-management among individuals with BD found that 41.6% of participants reported using a self-management app related to mood and/or sleep [ 32 ]. The most nominated app for mood monitoring was Daylio, and the most reported app for sleep monitoring was Fitbit.…”

Lithium levels and lifestyle in patients with bipolar disorder: a new tool for self-management

“…Whereas the influence of weight on lithium levels has been the subject of previous research (Grandjean and Lithium 2009), the influence of diet, sleep (Spano et al 2022), and physical activity has been neglected. Sleep is one of the most important lifestyle factors in BD and its regularity is used as a therapeutic tool to improve prognosis (Morton et al 2022). With respect to body size, weight is related to creatinine clearance, the most important factor related to lithium levels (ElDesoky et al 2008;Methaneethorn and Sringam 2019).…”