Novel app helps prevent recurrence in patients with mood disorders

A smartphone application (app) that helps stabilize circadian rhythm reduces the rate of recurrence and improves the clinical course in patients with major depressive disorder (MDD) or bipolar disorder (BD), according to a study.

Dubbed the Circadian Rhythm for Mood (CRM), the app provides “individualized 3-day mood forecasts and delivers personalized circadian rhythm feedback using passive sensor data,” the authors said.

To test the therapeutic efficacy of the app, 93 adults with MDD or BD were randomized to active CRM (n=47) or a sham app (n=46) for 12 months. Participants in the active CRM group received personalized circadian rhythm stabilization feedback generated by machine learning, while those in the sham app group received nonactionable feedback from a dummy algorithm, designed not to influence circadian behaviour, with a visually identical interface.

In the modified intention-to-treat cohort (n=80), the sham group (n=42) exhibited a higher rate of recurrence than the active CRM group (n=38; incidence rate ratio, 3.39, 95 percent confidence interval [CI], 1.86‒6.17). Furthermore, the sham group had higher cumulative recurrent episode-days per person-year (duration rate ratio, 2.76, 95 percent CI, 1.19‒6.40), while the active CRM group had more favourable time to recurrence (hazard ratio, 3.03, 95 percent CI, 1.58‒5.81).

Significant adverse effects were not reported in either group.

“CRM has potential as an innovative, scalable digital chronotherapeutic adjunct to standard care,” the authors said.