Voice analyses using smartphone-based data in patients with bipolar disorder, unaffected relatives and healthy...

Voice features have been suggested as objective markers of bipolar disorder (BD).

To investigate whether voice features from naturalistic phone calls could discriminate between (1) BD, unaffected first-degree relatives (UR) and healthy control individuals (HC); (2) affective states within BD.

Voice features were collected daily during naturalistic phone calls for up to 972 days. A total of 121 patients with BD, 21 UR and 38 HC were included. A total of 107.033 voice data entries were collected [BD (n  = 78.733), UR (n  = 8004), and HC (n  =  20.296)]. Daily, patients evaluated symptoms using a smartphone-based system. Affective states were defined according to these evaluations. Data were analyzed using random forest machine learning algorithms.

Compared to HC, BD was classified with a sensitivity of 0.79 (SD 0.11)/AUC  = 0.76 (SD 0.11) and UR with a sensitivity of 0.53 (SD 0.21)/AUC of 0.72 (SD 0.12). Within BD, compared to euthymia, mania was classified with a specificity of 0.75 (SD 0.16)/AUC  =  0.66 (SD 0.11). Compared to euthymia, depression was classified with a specificity of 0.70 (SD 0.16)/AUC  =  0.66 (SD 0.12). In all models the user dependent models outperformed the user independent models. Models combining increased mood, increased activity and insomnia compared to periods without performed best with a specificity of 0.78 (SD 0.16)/AUC  =  0.67 (SD 0.11).

Voice features from naturalistic phone calls may represent a supplementary objective marker discriminating BD from HC and a state marker within BD.