Effects of smartphone-based interventions and monitoring on bipolar disorder:A systematic review and meta-analysis

• 作者: Guang-Lin Zhu Jia-Yuan Liu Kang-Kang Xu Qi-Qi Zhang Xiao-Ming Li
• 来源期刊: 世界精神病学杂志
• 学科: 医学
• 关键词: SMARTPHONE Bipolar disorder MONITORING Interventions META-ANALYSIS Systematic review
• 年，卷（期）: 2020,（11）
• 页码范围: 272-285
• 页数: 14页
• 分类号: R73

摘要

BACKGROUND Recently,there has been a range of studies about smartphone-based interventions and monitoring for reducing symptoms of bipolar disorder(BD).However,their efficacy for BD remains unclear.AIM To compare the effect of smartphone-based interventions and monitoring with control methods in treating patients with BD.METHODS A systematic literature search was performed on PubMed,Embase,Clinical trials,psycINFO,Web of Science,and Cochrane Library.Randomized clinical trials(RCTs)or single-group trials in which smartphone-based interventions and monitoring were compared with control methods or baseline in patients with symptoms of BD were included.Data were synthesized using a random-effects or a fixed-effects model to analyze the effects of psychological interventions and monitoring delivered via smartphone on psychiatric symptoms in patients with BD.The primary outcome measures were set for mania and depression symptoms.Subgroups were created to explore which aspects of smartphone interventions are relevant to the greater or lesser efficacy of treating symptoms.RESULTS We identified ten articles,including seven RCTs(985 participants)and three single-group trials(169 participants).Analysis of the between-group study showed that smartphone-based interventions were effective in reducing manic[g=-0.19,95%confidence interval(CI):-0.33 to-0.04,P=0.01]and depressive(g=-0.28,95%CI:-0.55 to-0.01,P<0.05)symptoms.In within-group analysis,smartphone-based interventions significantly reduced manic(g=0.17,95%CI:0.04 to 0.30,P<0.01)and depressive(g=0.48,95%CI:0.18 to 0.78)symptoms compared to the baseline.Nevertheless,smartphone-based monitoring systems significantly reduced manic(g=0.27,95%CI:0.02 to 0.51,P<0.05)but not depressive symptoms.Subgroup analysis indicated that the interventions with psychoeducation had positive effects on depressive(g=-0.62,95%CI:-0.81 to-0.43,P<0.01)and manic(g=-0.24,95%CI:-0.43 to-0.06,P=0.01)symptoms compared to the controlled conditions,while the interventions without psychoeducation did not