Digital Phenotyping to Quantify Psychosocial Well-Being Trajectories After Spinal Cord Injury

Objective The aim of the study was to explore feasibility of smartphone-based digital phenotyping methods to examine depression and its relation to psychosocial well-being indicators after spinal cord injury. Design Smartphone research platform obtained smartphone sensor and survey data among community-living adult wheelchair users with spinal cord injury. Weekly measurements for 4 mos included Patient Health Questionnaire 8, Spinal Cord Injury-Quality of Life Satisfaction with and ability to participate in social roles and activities, global positioning system-derived community mobility metrics, health conditions, and physical activity. Results Forty-three individuals were enrolled. Study retention was higher among individuals offered financial incentives (78%) compared with participants enrolled before incentives (50%). Participants who dropped out more commonly had nontraumatic or acute spinal cord injury, were older, and had less satisfaction and lower participation in social roles and activities. Among 15 individuals with complete data, half had 1 wk or more of mild depression. Those with depression had frequent health issues, less satisfaction, and lower participation in social roles and activities. Those without depression experienced increased social engagement over time. Average community mobility was similar across depression groups. Relationships were typically in-phase but also varied by individual. Conclusions Smartphone-based digital phenotyping of psychosocial well-being after spinal cord injury is feasible but not without attrition challenges. Individual differences in depression patterns highlight clinical utility of scaling these methods.