DIGITAL PHENOTYPING AS A NOVEL CLINICAL BIOMARKER: ASSESSING THE DIAGNOSTIC EFFICACY, ARTIFICIAL INTELLIGENCE INTEGRATION, AND SOCIO-ETHICAL IMPLICATIONS IN PSYCHIATRIC CARE
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.5838Keywords:
Digital Phenotyping, Clinical Biomarkers, Artificial Intelligence, Psychiatry, Machine Learning, Medical Ethics, Technological Innovations.Abstract
Modern psychiatry relies heavily on subjective clinical assessments and patient reports, which often limits diagnostic accuracy. Digital phenotyping, defined as the collection of objective, continuous behavioural data using smartphones and wearables, is emerging as a promising source of novel clinical biomarkers. This review article aims to critically assess the diagnostic efficacy of digital phenotyping, its integration with artificial intelligence (AI) algorithms, and the socio-ethical implications in psychiatric care. An analysis of the available literature indicates that data derived from passive and active monitoring can be successfully used to objectify diagnosis and predict symptom exacerbations, including in affective and psychotic disorders. The integration of digital biomarkers with machine learning models enables the identification of hidden behavioural patterns, paving the way for personalised medicine. Despite their enormous clinical potential, the widespread implementation of these technologies faces significant barriers. These include socio-ethical challenges, such as privacy protection, data security, difficulties in obtaining fully informed consent, as well as the risk of stigmatisation and algorithmic bias. Furthermore, the continuous monitoring of patients raises questions about the impact of technology on trust and the therapeutic relationship. In summary, although AI-supported digital phenotyping represents a potential breakthrough in psychiatry, its safe implementation requires rigorous clinical validation and the establishment of a robust ethical framework to protect patients.
References
Oudin A., Maatoug R., Bourla A., Ferreri F., Bonnot O., Millet B., Schoeller F., Mouchabac S., Adrien V. (2023). Digital phenotyping: Data-Driven psychiatry to redefine mental health. Journal of Medical Internet Research, 25, e44502. https://doi.org/10.2196/44502
Torous J., Bucci S., Bell I.H., Kessing L.V., Faurholt-Jepsen M., Whelan P., Carvalho A.F., Keshavan M., Linardon J., Firth J. (2021). The growing field of digital psychiatry: Current evidence and the future of apps, social media, chatbots, and virtual reality. World Psychiatry, 20(3), 318-335.
Neuropsychopharmacology (Editorial). (2021). Big data in psychiatry: Multiomics, neuroimaging, computational modeling, and digital phenotyping. Neuropsychopharmacology, 46, 1-2. https://doi.org/10.1038/s41386-020-00862-x
Mouchabac S., Conejero I., Lakhlifi C., Msellek I., Malandain L., Adrien V., Ferreri F., Millet B., Bonnot O., Bourla A., Maatoug R. (2021). Improving clinical decision-making in psychiatry: Implementation of digital phenotyping could mitigate the influence of patient's and practitioner's individual cognitive biases. Dialogues in Clinical Neuroscience, 23(1), 52-61. https://doi.org/10.1080/19585969.2022.2042165
Lydon-Staley D.M., Barnett I., Satterthwaite T.D., Bassett D.S. (2019). Digital phenotyping for psychiatry: Accommodating data and theory with network science methodologies. Current Opinion in Biomedical Engineering, 9, 8-13. https://doi.org/10.1016/j.cobme.2018.12.003
Stanghellini G., Leoni F. (2020). Digital phenotyping: Ethical issues, opportunities, and threats. Frontiers in Psychiatry, 11, 473. https://doi.org/10.3389/fpsyt.2020.00473
Huckvale K., Venkatesh S., Christensen H. (2019). Toward clinical digital phenotyping: A timely opportunity to consider purpose, quality, and safety. npj Digital Medicine, 2(1).
Kiang M.V., Chen J.T., Krieger N., Buckee C.O., Alexander M.J., Baker J.T., Buckner R.L., Coombs III G., Rich-Edwards J.W., Carlson K.W., Onnela J.P. (2021). Sociodemographic characteristics of missing data in digital phenotyping. Scientific Reports, 11, 15408. https://doi.org/10.1038/s41598-021-94516-7
Nees F., Deserno L., Holz N.E., Romanos M., Banaschewski T. (2021). Prediction along a developmental perspective in psychiatry: How far might we go? Frontiers in systems neuroscience, 15, 670404. https://doi.org/10.3389/fnsys.2021.670404
Piau A., Wild K., Mattek N., Kaye J. (2019). Current state of digital biomarker technologies for Real-Life, Home-Based monitoring of cognitive function for mild cognitive impairment to mild alzheimer disease and implications for clinical care: Systematic review. Journal of Medical Internet Research, 21(8), e12785. https://doi.org/10.2196/12785
Kalman J.L., Burkhardt G., Samochowiec J., Gebhard C., Dom G., John M., Kilic O., Kurimay T., Lien L., Schouler-Ocak M., Vidal D.P., Wiser J., Gaebel W., Volpe U., Falkai P. (2024). Digitalising mental health care: Practical recommendations from the European psychiatric association. European Psychiatry, 67(1), e4, 1-7. https://doi.org/10.1192/j.eurpsy.2023.2466
Derks E.M., Gamazon E.R. (2020). Integration of genetics with -omics data in psychiatry. World Psychiatry, 19(1).
Vaidyam A., Halamka J., Torous J. Actionable digital phenotyping: a framework for the delivery of just-in-time and longitudinal interventions in clinical healthcare. Technical Report. Beth Israel Deaconess Medical Center, Harvard Medical School.
Barnett I., Torous J., Reeder H.T., Baker J., Onnela J.P. (2020). Determining sample size and length of follow-up for smartphone-based digital phenotyping studies. Journal of the American Medical Informatics Association, 27(12), 1844-1849. https://doi.org/10.1093/jamia/ocaa201
Jagesar R.R., Vorstman J.A., Kas M.J. (2021). Requirements and operational guidelines for secure and sustainable digital phenotyping: Design and development study. Journal of Medical Internet Research, 23(4), e20996. https://doi.org/10.2196/20996
Galatzer-Levy I.R., Onnela J.P. (2023). Machine learning and the digital measurement of psychological health. Annual Review of Clinical Psychology, 19, 133-154. https://doi.org/10.1146/annurev-clinpsy-080921-073212
Goldstein-Piekarski A.N., Holt-Gosselin B., O'Hora K., Williams L.M. (2020). Integrating sleep, neuroimaging, and computational approaches for precision psychiatry. Neuropsychopharmacology, 45, 192-204.
Huang D., Emedom-Nnamdi P., Onnela J.P., Van Meter A. (2025). Design and feasibility of smartphone-based digital phenotyping for long-term mental health monitoring in adolescents. PLOS Digital Health, 4(7), e0000883. https://doi.org/10.1371/journal.pdig.0000883
Kilshaw R.E., Boggins A., Everett O., Butner E., Leifker F.R., Baucom B.R.W. (2024). Benchmarking mental health status using passive sensor data: Protocol for a prospective observational study. JMIR Research Protocols, 13, e53857. https://doi.org/10.2196/53857
Barron D.S., Baker J.T., Budde K.S., Bzdok D., Eickhoff S.B., Friston K.J., Fox P.T., Geha P., Heisig S., Holmes A., Onnela J.P., Powers A., Silbersweig D., Krystal J.H. (2021). Decision models and technology can help psychiatry develop biomarkers. Frontiers in Psychiatry, 12, 706655. https://doi.org/10.3389/fpsyt.2021.706655
Chen I.M., Chen Y.Y., Liao S.C., Lin Y.H. (2022). Development of digital biomarkers of mental illness via mobile apps for personalized treatment and diagnosis. Journal of Personalized Medicine, 12(6), 936. https://doi.org/10.3390/jpm12060936
Montag C., Quintana D.S. (2023). Digital phenotyping in molecular psychiatry-a missed opportunity? Molecular psychiatry, 28, 6-9. https://doi.org/10.1038/s41380-022-01795-1
Slack S.K., Barclay L. (2023). First-person disavowals of digital phenotyping and epistemic injustice in psychiatry. Medicine, Health Care and Philosophy, 26, 605-614. https://doi.org/10.1007/s11019-023-10174-8
Torous J., Blease C. (2024). Return of results in digital phenotyping: Ethical considerations for Real-World use cases. The American Journal of Bioethics, 24(2), 91-93. https://doi.org/10.1080/15265161.2024.2298146
Bond R.R., Mulvenna M.D., Potts C., O'Neill S., Ennis E., Torous J. (2023). Digital transformation of mental health services. npj Mental Health Research, 2, 13.
O'Leary A., Lahey T., Lovato J., Loftness B., Douglas A., Skelton J., Cohen J.G., Copeland W.E., McGinnis R.S., McGinnis E.W. (2024). Using wearable digital devices to screen children for mental health conditions: Ethical promises and challenges. Sensors, 24, 3214. https://doi.org/10.3390/s24103214
Vlisides-Henry R.D., Gao M., Thomas L., Kaliush P.R., Conradt E., Crowell S.E. (2021). Digital phenotyping of emotion dysregulation across lifespan transitions to better understand psychopathology risk. Frontiers in Psychiatry, 12, 618442. https://doi.org/10.3389/fpsyt.2021.618442
Hurley M.E., Sonig A., Herrington J., Storch E.A., Lázaro-Muñoz G., Blumenthal-Barby J., Kostick-Quenet K. (2024). Ethical considerations for integrating multimodal computer perception and neurotechnology. Frontiers in Human Neuroscience, 18, 1332451. https://doi.org/10.3389/fnhum.2024.1332451
Olawade J.O., Ebo T.O., Alabi J.O., Makanjuola B.D., Egbon E., Olawade D.B. (2026). Digital twin technology in forensic mental health. Journal of Forensic and Legal Medicine, 120, 103137.
Loch A.A., Lopes-Rocha A.C., Ara A., Gondim J.M., Cecchi G.A., Corcoran C.M., Mota N.B., Argolo F.C. (2022). Ethical implications of the use of language analysis technologies for the diagnosis and prediction of psychiatric disorders. JMIR Mental Health, 9(11), e41014. https://doi.org/10.2196/41014
Haines-Delmont A., Chahal G., Bruen A.J., Wall A., Khan C.T., Sadashiv R., Fearnley D. (2020). Testing suicide risk prediction algorithms using phone measurements with patients in acute mental health settings: Feasibility study. JMIR mHealth and uHealth, 8(6), e15901. https://doi.org/10.2196/15901
Bourla A., Ferreri F., Ogorzelec L., Peretti C.S., Guinchard C., Mouchabac S. (2018). Psychiatrists' attitudes toward disruptive new technologies: Mixed-Methods study. JMIR Mental Health, 5(4), e10240. https://doi.org/10.2196/10240
Montag C., Elhai J.D., Dagum P. (2021). On blurry boundaries when defining digital biomarkers: How much biology needs to be in a digital biomarker? Frontiers in psychiatry, 12, 740292. https://doi.org/10.3389/fpsyt.2021.740292
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