Longitudinal Relationships Between Depressive Symptom Severity and Phone-Measured Mobility: Dynamic Structural Equation Modeling Study

Yuezhou Zhang; Amos A Folarin; Shaoxiong Sun; Nicholas Cummins; Srinivasan Vairavan; Rebecca Bendayan; Yatharth Ranjan; Zulqarnain Rashid; Pauline Conde; Callum Stewart; Petroula Laiou; Heet Sankesara; Faith Matcham; Katie M White; Carolin Oetzmann; Alina Ivan; Femke Lamers; Sara Siddi; Elisabet Vilella; Sara Simblett; Aki Rintala; Stuart Bruce; David C Mohr; Inez Myin-Germeys; Til Wykes; Josep Maria Haro; Brenda Wjh Penninx; Vaibhav A Narayan; Peter Annas; Matthew Hotopf; Richard Jb Dobson; RADAR-CNS consortium

doi:10.2196/34898

Longitudinal Relationships Between Depressive Symptom Severity and Phone-Measured Mobility: Dynamic Structural Equation Modeling Study

JMIR Ment Health. 2022 Mar 11;9(3):e34898. doi: 10.2196/34898.

Authors

Yuezhou Zhang¹, Amos A Folarin^{1

2

3

4

5}, Shaoxiong Sun¹, Nicholas Cummins¹, Srinivasan Vairavan⁶, Rebecca Bendayan^{1

3}, Yatharth Ranjan¹, Zulqarnain Rashid¹, Pauline Conde¹, Callum Stewart¹, Petroula Laiou¹, Heet Sankesara¹, Faith Matcham⁷, Katie M White⁷, Carolin Oetzmann⁷, Alina Ivan⁷, Femke Lamers⁸, Sara Siddi^{9

10

11}, Elisabet Vilella^{10

12}, Sara Simblett¹³, Aki Rintala^{14

15}, Stuart Bruce¹⁶, David C Mohr¹⁷, Inez Myin-Germeys¹⁴, Til Wykes^{13

18}, Josep Maria Haro^{9

10

11}, Brenda Wjh Penninx⁸, Vaibhav A Narayan⁶, Peter Annas¹⁹, Matthew Hotopf^{3

7

18}, Richard Jb Dobson^{1

2

3

4

5}; RADAR-CNS consortium²⁰

Affiliations

¹ Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
² Institute of Health Informatics, University College London, London, United Kingdom.
³ NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom.
⁴ Health Data Research UK London, University College London, London, United Kingdom.
⁵ NIHR Biomedical Research Centre at University College London Hospitals NHS Foundation Trust, London, United Kingdom.
⁶ Janssen Research and Development LLC, Titusville, NJ, United States.
⁷ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
⁸ Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam University Medical Centre, Vrije Universiteit and GGZ inGeest, Amsterdam, Netherlands.
⁹ Teaching Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain.
¹⁰ Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
¹¹ Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.
¹² Hospital Universitari Institut Pere Mata, Institute of Health Research Pere Virgili, Universitat Rovira i Virgili, Reus, Spain.
¹³ Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
¹⁴ Center for Contextual Psychiatry, Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium.
¹⁵ Faculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland.
¹⁶ RADAR-CNS Patient Advisory Board, King's College London, London, United Kingdom.
¹⁷ Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Evanston, IL, United States.
¹⁸ South London and Maudsley NHS Foundation Trust, London, United Kingdom.
¹⁹ H. Lundbeck A/S, Copenhagen, Denmark.
²⁰ See Acknowledgments, .

PMID: 35275087
PMCID: PMC8957008
DOI: 10.2196/34898

Abstract

Background: The mobility of an individual measured by phone-collected location data has been found to be associated with depression; however, the longitudinal relationships (the temporal direction of relationships) between depressive symptom severity and phone-measured mobility have yet to be fully explored.

Objective: We aimed to explore the relationships and the direction of the relationships between depressive symptom severity and phone-measured mobility over time.

Methods: Data used in this paper came from a major EU program, called the Remote Assessment of Disease and Relapse-Major Depressive Disorder, which was conducted in 3 European countries. Depressive symptom severity was measured with the 8-item Patient Health Questionnaire (PHQ-8) through mobile phones every 2 weeks. Participants' location data were recorded by GPS and network sensors in mobile phones every 10 minutes, and 11 mobility features were extracted from location data for the 2 weeks prior to the PHQ-8 assessment. Dynamic structural equation modeling was used to explore the longitudinal relationships between depressive symptom severity and phone-measured mobility.

Results: This study included 2341 PHQ-8 records and corresponding phone-collected location data from 290 participants (age: median 50.0 IQR 34.0, 59.0) years; of whom 215 (74.1%) were female, and 149 (51.4%) were employed. Significant negative correlations were found between depressive symptom severity and phone-measured mobility, and these correlations were more significant at the within-individual level than the between-individual level. For the direction of relationships over time, Homestay (time at home) (φ=0.09, P=.01), Location Entropy (time distribution on different locations) (φ=-0.04, P=.02), and Residential Location Count (reflecting traveling) (φ=0.05, P=.02) were significantly correlated with the subsequent changes in the PHQ-8 score, while changes in the PHQ-8 score significantly affected (φ=-0.07, P<.001) the subsequent periodicity of mobility.

Conclusions: Several phone-derived mobility features have the potential to predict future depression, which may provide support for future clinical applications, relapse prevention, and remote mental health monitoring practices in real-world settings.

Keywords: depression; dynamic structural equation modeling; location data; mHealth; medical informatics; mental health; mobile health; mobility; modeling.

©Yuezhou Zhang, Amos A Folarin, Shaoxiong Sun, Nicholas Cummins, Srinivasan Vairavan, Rebecca Bendayan, Yatharth Ranjan, Zulqarnain Rashid, Pauline Conde, Callum Stewart, Petroula Laiou, Heet Sankesara, Faith Matcham, Katie M White, Carolin Oetzmann, Alina Ivan, Femke Lamers, Sara Siddi, Elisabet Vilella, Sara Simblett, Aki Rintala, Stuart Bruce, David C Mohr, Inez Myin-Germeys, Til Wykes, Josep Maria Haro, Brenda WJH Penninx, Vaibhav A Narayan, Peter Annas, Matthew Hotopf, Richard JB Dobson, RADAR-CNS consortium. Originally published in JMIR Mental Health (https://mental.jmir.org), 11.03.2022.

Abstract

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