Feasibility of a wrist-worn wearable device for estimating mental health status in patients with mental illness

Kazuyuki Nakagome; Manabu Makinodan; Mitsuhiro Uratani; Masaki Kato; Norio Ozaki; Seiko Miyata; Kunihiro Iwamoto; Naoki Hashimoto; Atsuhito Toyomaki; Kazuo Mishima; Masaya Ogasawara; Masahiro Takeshima; Kazumichi Minato; Toshikazu Fukami; Mari Oba; Kazuyoshi Takeda; Hideki Oi

doi:10.3389/fpsyt.2023.1189765

Feasibility of a wrist-worn wearable device for estimating mental health status in patients with mental illness

Front Psychiatry. 2023 Jul 20:14:1189765. doi: 10.3389/fpsyt.2023.1189765. eCollection 2023.

Authors

Kazuyuki Nakagome¹, Manabu Makinodan², Mitsuhiro Uratani², Masaki Kato³, Norio Ozaki^{4

5}, Seiko Miyata⁵, Kunihiro Iwamoto⁵, Naoki Hashimoto⁶, Atsuhito Toyomaki⁶, Kazuo Mishima⁷, Masaya Ogasawara⁷, Masahiro Takeshima⁷, Kazumichi Minato⁸, Toshikazu Fukami⁸, Mari Oba⁹, Kazuyoshi Takeda⁹, Hideki Oi⁹

Affiliations

¹ Department of Psychiatry, National Center of Neurology and Psychiatry, Kodaira, Japan.
² Department of Psychiatry, Nara Medical University, Kashihara, Japan.
³ Department of Neuropsychiatry, Kansai Medical University, Hirakata, Japan.
⁴ Pathophysiology of Mental Disorders, Nagoya University Graduate School of Medicine, Nagoya, Japan.
⁵ Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
⁶ Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
⁷ Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan.
⁸ TechDoctor Inc., Tokyo, Japan.
⁹ Department of Clinical Data Science, National Center of Neurology and Psychiatry, Kodaira, Japan.

Abstract

Object: Real-world data from wearable devices has the potential to understand mental health status in everyday life. We aimed to investigate the feasibility of estimating mental health status using a wrist-worn wearable device (Fitbit Sense) that measures movement using a 3D accelerometer and optical pulse photoplethysmography (PPG).

Methods: Participants were 110 patients with mental illnesses from different diagnostic groups. The study was undertaken between 1 October 2020 and 31 March 2021. Participants wore a Fitbit Sense on their wrist and also completed the State-Trait Anxiety Inventory (STAI), Positive and Negative Affect Schedule (PANAS), and EuroQol 5 dimensions 5-level (EQ-5D-5L) during the study period. To determine heart rate (HR) variability (HRV), we calculated the sdnn (standard deviation of the normal-to-normal interval), coefficient of variation of R-R intervals, and mean HR separately for each sleep stage and the daytime. The association between mental health status and HR and HRV was analyzed.

Results: The following significant correlations were found in the wake after sleep onset stage within 3 days of mental health status assessment: sdnn, HR and STAI scores, HR and PANAS scores, HR and EQ-5D-5L scores. The association between mental health status and HR and HRV was stronger the closer the temporal distance between mental health status assessment and HR measurement.

Conclusion: A wrist-worn wearable device that measures PPG signals was feasible for use with patients with mental illness. Resting state HR and HRV could be used as an objective assessment of mental health status within a few days of measurement.

Keywords: Mental Illness Registry; anxiety; heart rate; quality of life; wearable device.