{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:03:18Z","timestamp":1790269398298,"version":"4.1.0"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 107-2314-B-006-020-MY3, MOST 110-2314-B-006-0"],"award-info":[{"award-number":["MOST 107-2314-B-006-020-MY3, MOST 110-2314-B-006-0"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Telemed Telecare"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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; \u226520% 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u20130.87) and emergency department visits (adjusted odds ratio = 0.28, 95% confidence interval = 0.08\u20130.98).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1357633x261489680","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:21:06Z","timestamp":1790076066000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between MoodSensing smartphone application use and psychiatric readmissions and emergency department visits among patients with bipolar disorder in Taiwan"],"prefix":"10.1177","author":[{"given":"Tim Jhao-Lin","family":"Tu","sequence":"first","affiliation":[{"name":"National Cheng Kung University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5686-9296","authenticated-orcid":false,"given":"Jia-Yin","family":"Syu","sequence":"additional","affiliation":[{"name":"National Cheng Kung University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po See","family":"Chen","sequence":"additional","affiliation":[{"name":"Ministry of Health and Welfare"},{"name":"National Cheng Kung University"},{"name":"Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray Ruei-Yong","family":"Gao","sequence":"additional","affiliation":[{"name":"National Cheng Kung University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Hsiang","family":"Lin","sequence":"additional","affiliation":[{"name":"National Cheng Kung University"},{"name":"Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan"},{"name":"National Cheng Kung University Hospital"},{"name":"National Cheng Kung University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5134-1700","authenticated-orcid":false,"given":"Esther Ching-Lan","family":"Lin","sequence":"additional","affiliation":[{"name":"National Cheng Kung University Hospital"},{"name":"National Cheng Kung University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31544-0"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20021155"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291721005377"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.18588"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-023-04960-0"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.06.086"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2024.11.014"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s43678-021-00204-w"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2024.30.1.72"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.13464"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.4103\/TPSY.TPSY_9_22"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248152"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.13362"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2022.114425"},{"key":"e_1_3_3_16_2","article-title":"Assessing progression in bipolar disorder: A staging model tested in a sample over ten years of observation","volume":"66","author":"Girone N","year":"2023","unstructured":"Girone N, Macellaro M, Cremaschi L, et al. 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