Associations between MoodSensing smartphone application use and psychiatric readmissions and emergency department visits among patients with bipolar disorder in Taiwan

Introduction This study examined the association between the frequency of MoodSensing smartphone application (MS app) use and psychiatric readmissions and emergency department visits among patients with bipolar disorder. Methods A 6-month prospective observational pilot study was conducted among 183 patients with bipolar disorder recruited from the psychiatric outpatient department of a medical center in Taiwan. Participants were followed for 6 months and categorized into usage groups based on MS app usage frequency (unused, low-usage, and active users; ≥20% usage defined as active use). Outcomes included psychiatric readmissions and emergency department visits within 6 months, obtained from medical records. Associations between application use and outcomes were analyzed using Firth's logistic regression to account for rare events, adjusting for demographic characteristics and clinical covariates. Results Participants had a mean age of 36.6 years, 57.4% were female, and the mean duration of bipolar disorder was 14.5 years. Overall, 157 participants (85.8%) used the MS app at least once during the 6-month follow-up. Compared with the unused group, active users had significantly lower adjusted odds of psychiatric readmissions (adjusted odds ratio = 0.13, 95% confidence interval = 0.02–0.87) and emergency department visits (adjusted odds ratio = 0.28, 95% confidence interval = 0.08–0.98). Discussion Active MS app use was associated with lower odds of psychiatric readmissions and emergency department visits. Given the uncontrolled observational pilot design, these findings should be considered preliminary.