Fedor, S., Lewis, R., Pedrelli, P., Mischoulon, D., Curtiss, J., & Picard, R. W. (2023). Wearable technology in clinical practice for depressive disorder. New England Journal of Medicine, 389(26), 2457-2466.

Abstract

Treatment of depression is based on evaluation for the presence and severity of symptoms. Depression is mostly diagnosed and monitored by means of interview-based assessments or self-report scales, which include questions about current circumstances, personal history, family history, and the frequency of symptoms attributable to depression.

Much of this information is subjective (i.e., based on the patient’s report) and shaped by the clinician’s judgment. Hence, it is prone to various biases that may affect the quality of care. Researchers have suggested various explanations for these biases.

Self-report scales have been used to remotely monitor patients’ symptoms between clinical visits. If these instruments (e.g., the Patient Health Questionnaire 9 [PHQ-9], which scores depression on a scale from 0 to 27, with higher numbers indicating more severe symptoms) are administered regularly, they can reduce retrospective bias. However, the burden on the patient can limit how frequently questionnaires are collected. Indeed, adherence to questionnaires is reduced with an increase in the frequency or period of administration.