A narrative review of digital biomarkers in the management of major depressive disorder and treatment-resistant forms

Annarita Vignapiano; Francesco Monaco; Claudio Pagano; Martina Piacente; Federica Farina; Gianvito Petrillo; Raffaella Sica; Alessandra Marenna; Jae Il Shin; Marco Solmi; Giulio Corrivetti

doi:10.3389/fpsyt.2023.1321345

A narrative review of digital biomarkers in the management of major depressive disorder and treatment-resistant forms

Front Psychiatry. 2023 Nov 23:14:1321345. doi: 10.3389/fpsyt.2023.1321345. eCollection 2023.

Authors

Annarita Vignapiano^#^{1

2}, Francesco Monaco^#^{1

2}, Claudio Pagano^{3

4}, Martina Piacente², Federica Farina², Gianvito Petrillo⁴, Raffaella Sica¹, Alessandra Marenna², Jae Il Shin^{5

6}, Marco Solmi^{7

8

9

10

11}, Giulio Corrivetti^{1

2}

Affiliations

¹ Department of Mental Health, Salerno, Italy.
² European Biomedical Research Institute of Salerno (EBRIS), Salerno, Italy.
³ Dipartimento di Scienze Aziendali-Managment e Innovation Systems, Università di Salerno, Salerno, Italy.
⁴ Innovation Tecnology e Sviluppo (I.T. Svil), Salerno, Italy.
⁵ Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁶ Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea.
⁷ Department of Psychiatry, University of Ottawa, Ontario, ON, Canada.
⁸ On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, ON, Canada.
⁹ Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
¹⁰ School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
¹¹ Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin, Berlin, Germany.

^# Contributed equally.

Abstract

Introduction: Depression is the leading cause of worldwide disability, until now only 3% of patients with major depressive disorder (MDD) experiences full recovery or remission. Different studies have tried to better understand MDD pathophysiology and its resistant forms (TRD), focusing on the identification of candidate biomarkers that would be able to reflect the patients' state and the effects of therapy. Development of digital technologies can generate useful digital biomarkers in a real-world setting. This review aims to focus on the use of digital technologies measuring symptom severity and predicting treatment outcomes for individuals with mood disorders.

Methods: Two databases (PubMed and APA PsycINFO) were searched to retrieve papers published from January 1, 2013, to July 30, 2023, on the use of digital devices in persons with MDD. All papers had to meet specific inclusion criteria, which resulted in the inclusion of 12 articles.

Results: Research on digital biomarkers confronts four core aspects: (I) predicting diagnostic status, (II) assessing symptom severity and progression, (III) identifying treatment response and (IV) monitoring real-word and ecological validity. Different wearable technologies have been applied to collect physiological, activity/sleep, or subjective data to explore their relationships with depression.

Discussion: Depression's stable rates and high relapse risk necessitate innovative approaches. Wearable devices hold promise for continuous monitoring and data collection in real world setting.

Conclusion: More studies are needed to translate these digital biomarkers into actionable interventions to improve depression diagnosis, monitoring and management. Future challenges will be the applications of wearable devices routinely in personalized medicine.

Keywords: artificial intelligence; digital biomarkers; major depressive disorder; mental healthcare; personalized treatment; wearable devices.

Publication types

Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by POR CAMPANIA FESR 2014–2020 ASSE PRIORITARIO 3 (Grant No. 2022.108).