Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality
Open accessAbstract
BACKGROUND: With continued increases in smartphone ownership, researchers and clinicians are investigating the use of this technology to enhance the management of chronic illnesses such as bipolar disorder (BD). Smartphones can be used to deliver interventions and psychoeducation, supplement treatment, and enhance therapeutic reach in BD, as apps are cost-effective, accessible, anonymous, and convenient. While the evidence-based development of BD apps is in its infancy, there has been an explosion of publicly available apps. However, the opportunity for mHealth to assist in the self-management of BD is only feasible if apps are of appropriate quality. OBJECTIVE: Our aim was to identify the types of apps currently available for BD in the Google Play and iOS stores and to assess their features and the quality of their content. METHODS: A systematic review framework was applied to the search, screening, and assessment of apps. We searched the Australian Google Play and iOS stores for English-language apps developed for people with BD. The comprehensiveness and quality of information was assessed against core psychoeducation principles and current BD treatment guidelines. Management tools were evaluated with reference to the best-practice resources for the specific area. General app features, and privacy and security were also assessed. RESULTS: Of the 571 apps identified, 82 were included in the review. Of these, 32 apps provided information and the remaining 50 were management tools including screening and assessment (n=10), symptom monitoring (n=35), community support (n=4), and treatment (n=1). Not even a quarter of apps (18/82, 22%) addressed privacy and security by providing a privacy policy. Overall, apps providing information covered a third (4/11, 36%) of the core psychoeducation principles and even fewer (2/13, 15%) best-practice guidelines. Only a third (10/32, 31%) cited their information source. Neither comprehensiveness of psychoeducation information (r=-.11, P=.80) nor adherence to best-practice guidelines (r=-.02, P=.96) were significantly correlated with average user ratings. Symptom monitoring apps generally failed to monitor critical information such as medication (20/35, 57%) and sleep (18/35, 51%), and the majority of self-assessment apps did not use validated screening measures (6/10, 60%). CONCLUSIONS: In general, the content of currently available apps for BD is not in line with practice guidelines or established self-management principles. Apps also fail to provide important information to help users assess their quality, with most lacking source citation and a privacy policy. Therefore, both consumers and clinicians should exercise caution with app selection. While mHealth offers great opportunities for the development of quality evidence-based mobile interventions, new frameworks for mobile mental health research are needed to ensure the timely availability of evidence-based apps to the public.
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Studies report very few mental health applications with an adequate privacy policy or secure data transmission methods.
“Studies report very few mental health applications with an adequate privacy policy or secure data transmission methods (119–121).”
From Mobile intervention for individuals with psychosis, dual disorders, and their common comorbidities: A literature review (2019) · cites this paper as [120]
The Results (Privacy and Confidentiality; page not provided) report that only 18 of 82 bipolar-disorder apps had a privacy policy, supporting the claim that such policies were uncommon in the apps studied. The paper assesses policy availability, not whether policies were adequate, and it does not report whether apps used secure data transmission methods. (LLM, conf=0.88)
Experimental — accuracy not yet measuredNicholas et al. identified 82 apps developed for BD in the Google Play and Apple iOS stores.
“Nicholas et al. identified 82 apps developed for BD in the Google Play and Apple iOS stores (Nicholas et al. 2015).”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Nicholas et al. 2015
In Nicholas et al., only 22% of apps provided a privacy policy.
“Concerningly, only 22% provided a privacy policy”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Nicholas et al. 2015
In Nicholas et al., app content was largely not in line with guidelines for BD treatment, with some apps containing harmful or misleading content.
“app content was largely not in line with guidelines for BD treatment, with some apps containing harmful or misleading content.”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Nicholas et al. 2015
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Lagan, S., Ramakrishnan, A., Lamont, E., Ramakrishnan, A., Frye, M., & Torous, J. (2020) · International Journal of Bipolar Disorders · doi:10.1186/s40345-020-00202-4 · Cited by 50 · see citing works
Technology to assess and support self-management in serious mental illness
Depp, C. A., Moore, R. C., Perivoliotis, D., & Granholm, E. (2016) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2016.18.2/cdepp · Cited by 48 · see citing works
Internet use by patients with bipolar disorder: Results from an international multisite survey
Bauer, R., Conell, J., Glenn, T., Alda, M., Ardau, R., Baune, B. T., Berk, M., Bersudsky, Y., Bilderbeck, A., Bocchetta, A., et al. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.05.055 · Cited by 43 · see citing works
Users’ Perspectives on mHealth Self-Management of Bipolar Disorder: Qualitative Focus Group Study
Switsers, L., Dauwe, A., Vanhoudt, A., Van Dyck, H., Lombaerts, K., & Oldenburg, J. (2018) · JMIR mHealth and uHealth · doi:10.2196/mhealth.9529 · Cited by 33 · see citing works
“However, few mHealth apps for BD are evidence-based, most of them need to be better tailored to the needs and perspectives of people with BD [10,11], and user involvement remains a challenge [12,13].”
Pennou, A., Lecomte, T., Potvin, S., & Khazaal, Y. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00302 · Cited by 34 · see citing works
Issues for eHealth in Psychiatry: Results of an Expert Survey
Nicholas, J., Huckvale, K., Larsen, M. E., Basu, A., Batterham, P. J., Shaw, F., & Sendi, S. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.6957 · Cited by 34 · see citing works
Self-citationmHealth in psychiatry: time for methodological change
Nicholas, J., Boydell, K., & Christensen, H. (2016) · Evidence-Based Mental Health · doi:10.1136/eb-2015-102278 · Cited by 34 · see citing works
Self-citationBatterham, P. J., Calear, A. L., O’Dea, B., Larsen, M. E., J Kavanagh, D., Titov, N., March, S., Hickie, I., Teesson, M., Dear, B. F., et al. (2019) · DIGITAL HEALTH · doi:10.1177/2055207619878069 · Cited by 21 · see citing works
“It should also be noted that user star ratings within general app stores have been shown to have limited correlation with measures of the clinical quality of apps.(28) Establishing independent panels of clinician and consumer users to provide a consistent rating process may overcome some of these challenges.”
Self-citationHidalgo-Mazzei, D., Nikolova, V. L., Kitchen, S., & Young, A. H. (2019) · Digital Psychiatry · doi:10.1080/2575517x.2019.1616476 · Cited by 23 · see citing works
Morton, E., Nicholas, J., Yang, L., Lapadat, L., Barnes, S. J., Provencher, M. D., Depp, C., Chan, M., Kulur, R., & Michalak, E. E. (2022) · International Journal of Bipolar Disorders · doi:10.1186/s40345-022-00256-6 · Cited by 20 · see citing works
Self-citationPsychologists’ motivations for integrating apps into therapy with secondary school-aged young people
Gindidis, S., Stewart, S. E., & Roodenburg, J. (2020) · Journal of Psychologists and Counsellors in Schools · doi:10.1017/jgc.2019.22 · Cited by 6 · see citing works
Larsen, M., Nicholas, J., Han, J., Lemon, C., Okun, K., Torok, M., Wong, D., Wong, I., Wong, Q., & Huckvale, K. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-039817 · Cited by 5 · see citing works
Self-citation
- Authors
- Nicholas, J., Larsen, M. E., Proudfoot, J., & Christensen, H.
- Affiliations
- Black Dog Institute (AU)
- Corresponding author
- Nicholas, Jennifer
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2015-08-17
- Volume
- 17
- Issue
- 8
- Pages
- e198
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC4642376
- OpenAlex
- W2128900442
- Cited by
- 438
- References
- 39
- Citations by year
- 2026: 15 · 2025: 30 · 2024: 19 · 2023: 41 · 2022: 63 · 2021: 54 · 2020: 57 · 2019: 45 · 2018: 48 · 2017: 36 · 2016: 28 · 2015: 2
- FWCI
- 5.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Medical Research Council
- National Health and Medical Research Council (1042580, 1056964)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- bipolar disorder, mobile health apps, app quality assessment, psychoeducation, self-management, symptom monitoring, medication adherence, sleep monitoring, privacy and security, app store search, user ratings, mental health apps, privacy policy disclosure
- MeSH terms
- Smartphone, Australia, Bipolar Disorder, Humans, Patient Education as Topic, Self Care, Telemedicine, Privacy, Disease Management, Mobile Applications
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