Context-Aware Digital Phenotyping of Youth Mental Health Using Mobile Ecological Prospective Assessments of Smartphone Use

Abstract

Background: Youth mental disorders affect 12-14% of adolescents globally and remain underdiagnosed and undertreated. Digital phenotyping offers a scalable approach to real-time behavioural monitoring via smartphones, yet most studies rely solely on passive measures such as screen time, overlooking contextual factors. Methods: This cross-sectional study was part of the Smart Platform, a digital citizen science initiative that engaged youth aged 13-21 years. Participants completed a baseline survey on sociodemographic characteristics and mental health (depression, anxiety, and suicidal ideation). Over the next seven days, context-aware digital phenotyping was conducted, defined as the collection of ecologically valid, time-stamped behavioural data from personal devices. This was implemented through mobile ecological prospective assessments (mEPAs) to capture self-reported smartphone use context, including activity type, location, and social setting. Multivariable logistic regression assessed associations between smartphone use context and mental health, adjusting for sociodemographic covariates. Results: Eighty-four youth completed the baseline survey and at least one mEPA. A higher proportion of smartphone use at home was associated with lower odds of depression (OR=0.105, 95% CI: 0.028-0.276) and anxiety (OR=0.150, 0.053-0.345). A greater proportion of smartphone use while alone was associated with higher odds of depression (OR=3.802, 1.622-11.241), as was a greater proportion of time spent internet surfing (OR=2.663, 1.238-6.843). Longer duration of smartphone use outside the home was associated with higher odds of depression (OR=4.289, 1.443-16.579). Conclusion: Context-aware smartphone metrics may offer more informative digital phenotyping indicators of youth mental health than duration alone, supporting integration of multi-context measures into early detection and precision prevention frameworks.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study was funded by the Canada Research Chairs Program

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study received ethics approval through a harmonized review process from both the University of Regina and the University of Saskatchewan (REB #2017-29).

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Data Availability

All data produced in the present study are available upon reasonable request to the authors

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