Interview with Dr Faith Matcham on using technology to measure depression

Dr Faith Matcham is a post-doctoral research associate in the department of psychological medicine at King’s College London. Here she talks about her work coordinating the RADAR-CNS clinical study in major depressive disorder.

Depression is a condition that is very difficult to treat, and depressive episodes are hard to predict. How can mobile technology change that?

Mobile technology allows us to measure things we were never able to measure before. We can assess how somebody feels during the day and identify triggers that make this person feel bad. This is important because the reasons why someone slips into a depression greatly differ from person to person. Also, people’s experience of depression differs a lot from one person to the next: some people get physically ill or very emotional, whereas others have low energy and will barely leave the house. All these feelings translate to different behaviours, which we can measure with mobile technology. This allows us to make a personal profile of every individual. Because depression is such a complex condition, it is not feasible to assume that there is a ‘one-size-fits all’ solution. Getting the right treatment to the right patient faster would be a great step forward, and creating a personal profile with mobile technology could improve that process.

What’s more, mobile technology gives people insight into their condition. In our study, participants have direct access to their data. They can use that data to actively change their behaviour or discuss it with their caregiver or healthcare professional. Our ultimate goal is to predict whether someone is about to slip into a depression, to allow early intervention to prevent the next depressive episode. 

It sounds quite complicated to figure out if and how mobile technology can predict depression. How do you tackle this?

In our study, we’re following six hundred people in three countries over a period of two years. The participants suffered from depression before, and are at risk of slipping into a depression again. We want to find out whether commercially-available mobile phones and wearable sensors can pick up signals that say something useful about the mental state of the user. In order to figure that out, we collect data from a wristband with sensors, the sensors in a mobile phone, and from questionnaires that participants fill out on their phone.

What is it like for participants to take part in this study?

Two years is a long time to participate in a study, but luckily, participants don’t have to constantly think about the study. They install an app on their phone, which then runs in the background on their device. This app passively collects data, such as GPS location and phone use. Another app asks the participants to fill out a questionnaire every now and then. In addition, they wear a wristband with sensors, so that relevant data (on activity patterns, for example) can be collected. The good thing about this study is that all data can be remotely collected, so people don’t have to make regular visits to a clinic, for example. The researchers do keep in touch with the participants though, and this personal connection remains very important. This also helps to assess whether people are feeling comfortable using the technology. Even if you can collect amazing data, if people are uncomfortable, it will never be used in the real-life clinical setting.

The idea of using mobile technology for mental health is not new. What do you hope to add with your study?

Many of the studies that have been done with this technology are small and relatively short. Our study is one of the biggest and longest in the field. Also, many studies have been performed in healthy people and not in individuals with a history of depression. Our study also stands out because of the large number of sensors and parameters that we test. We look at sleep, speech, movement, social behaviour, cognitive functions, and other functions.

Smartphones started to gain popularity about ten years ago. Where do you think another ten years will take this technology?

I think that ten years from now, we won’t even recognise the phones that we are using today, just as we now barely recognise the phones that we used ten years ago. I clearly remember thinking: why on earth would I need a camera in my phone? But I have to admit that I haven’t touched my own camera in eight years, because I always use the camera in my smartphone. Who knows what the creative minds amongst us will come up with in the near future! Maybe there will be holograms of therapists, or the possibility to follow group therapy without having to leave your house. Whatever initiatives emerge, I would love to be part of the team that makes sure that the developed techniques are safe and effective before they are rolled out on a larger scale.