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Smartwatch-Derived Digital Phenotypes Relate to Psychopathology Dimensions in Patients With Psychotic Spectrum
Vasiliki Garyfalli1,2, Emmanouil Kalisperakis1,2, Alexandros Smyrnis1,3
1Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health Research Institute, Athens, Greece.
JMIR Mental Health
|December 12, 2025
Summary
Digital phenotyping using wearables shows specific behavioral changes linked to symptom dimensions in psychotic disorders. This offers new avenues for remote monitoring and biomarker discovery in personalized medicine.
Area of Science:
- Psychiatry and Digital Health
- Personalized Medicine
- Biomarker Research
Background:
- Digital phenotyping objectively measures behavior using devices like smartphones and watches for personalized medicine.
- Previous studies linked digital phenotypes to diagnosing psychotic disorders or predicting relapse, but with insufficient accuracy for clinical use.
- The 5-factor model of the Positive and Negative Syndrome Scale (PANSS) offers a refined clinical taxonomy to better capture symptom variability.
Purpose of the Study:
- To investigate the associations between digital phenotypes and each of the 5 dimensions of the PANSS.
- To determine if clinical, demographic, and medication variables confound these associations.
Main Methods:
- Continuous smartwatch data (heart rate, accelerometer, gyroscope, sleep) collected for up to 26 months from 38 patients with psychotic spectrum disorders.
- Monthly aggregated data were analyzed using linear mixed models to assess links between digital phenotypes and PANSS symptom dimensions.
Main Results:
- Positive symptoms correlated with reduced heart rate variability during sleep.
- Negative symptoms linked to decreased motor activity (accelerometer, gyroscope) during wakefulness.
- Sleep/wake activity and heart rate patterns associated with depression/anxiety, excitement/hostility, and cognitive/disorganization symptoms.
Conclusions:
- Digital phenotypes are characteristic of specific symptom clusters in psychotic disorders, not just diagnostic categories.
- These findings support digital phenotypes for remote patient monitoring and as potential biomarkers in psychiatric research.
Keywords:
bipolar disorderdigital phenotypeparasympathetic heart activationpsychopathology dimensionschizophreniasmartwatchsympathetic heart activationMore Related Videos
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