Assessing the feasibility of large-scale digital sensing for depression and anxiety: The Digital Mental Health Study

Data passively obtained from smartphones and wearables can provide nearly continuous objective information that enables quantification of states and traits across broad physiological, behavioral, and emotional domains impacted in mental health conditions, including depression and anxiety. Widespread application of such digital phenotyping could transform the assessment of depression and anxiety in research and clinical care, but the field has lacked well-powered longitudinal studies demonstrating the utility of this approach. This paper describes the design and implementation of the Digital Mental Health Study (DMHS), which collected up to 12 months of sensor data from iPhone and Apple Watch in more than 4,000 participants, a sample diverse by age, sex at birth, ethnicity, and depression symptom severity. To enable the use of these digital phenotypes to assay the complexity and heterogeneity of depression and anxiety, we designed a protocol of periodic self-report and interview-based scales optimized to assess elements of depression, anxiety, and perceived stress as broadly as possible while minimizing participant measurement burden. We report here the strategies used to recruit and enroll the DMHS sample, the process employed to develop study methods and protocols, and initial findings describing longitudinal symptom trajectories and demonstrating high participant engagement and adherence over a 12-month period.