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OBJECTIVE: Ubiquitous technologies can be leveraged to construct ecologically relevant metrics that complement traditional psychological assessments. This study aims to determine the feasibility of smartphone-derived real-world keyboard metadata to serve as digital biomarkers of mood. MATERIALS AND METHODS: BiAffect, a real-world observation study based on a freely available iPhone app, allowed the unobtrusive collection of typing metadata through a custom virtual keyboard that replaces the default keyboard. User demographics and self-reports for depression severity (Patient Health Questionnaire-8) were also collected. Using >14 million keypresses from 250 users who reported demographic information and a subset of 147 users who additionally completed at least 1 Patient Health Questionnaire, we employed hierarchical growth curve mixed-effects models to capture the effects of mood, demographics, and time of day on keyboard metadata. RESULTS: We analyzed 86 541 typing sessions associated with a total of 543 Patient Health Questionnaires. Results showed that more severe depression relates to more variable typing speed (P < .001), shorter session duration (P < .001), and lower accuracy (P < .05). Additionally, typing speed and variability exhibit a diurnal pattern, being fastest and least variable at midday. Older users exhibit slower and more variable typing, as well as more pronounced slowing in the evening. The effects of aging and time of day did not impact the relationship of mood to typing variables and were recapitulated in the 250-user group. CONCLUSIONS: Keystroke dynamics, unobtrusively collected in the real world, are significantly associated with mood despite diurnal patterns and effects of age, and thus could serve as a foundation for constructing digital biomarkers.

The increasing use of electronic forms of communication presents new opportunities in the study of mental health, including the ability to investigate the manifestations of psychiatric diseases unobtrusively and in the setting of patients' daily lives. A pilot study to explore the possible connections between bipolar affective disorder and mobile phone usage was conducted. In this study, participants were provided a mobile phone to use as their primary phone. This phone was loaded with a custom keyboard that collected metadata consisting of keypress entry time and accelerometer movement. Individual character data with the exceptions of the backspace key and space bar were not collected due to privacy concerns. We propose an end-to-end deep architecture based on late fusion, named DeepMood, to model the multi-view metadata for the prediction of mood scores. Experimental results show that 90.31% prediction accuracy on the depression score can be achieved based on session-level mobile phone typing dynamics which is typically less than one minute. It demonstrates the feasibility of using mobile phone metadata to infer mood disturbance and severity., Comment: KDD 2017