Digital/computational phenotyping: What are the differences in the science and the ethics?

The techno-politics of computing the mind: Opening the black box of digital psychiatry

Psychiatry has recently witnessed the launch of digital phenotyping as a new research agenda. According to digital phenotyping's hypothesis, data about a patient's daily behavior can be continuously collected through wearable monitoring devices and used to build software that would send warnings of mental relapse or would tailor treatment choices. The research is exploratory, and the claims upon which it is based are contentious. Drawing on interviews, we followed a research team that aspired to build a digital system that could send such warnings to patients with mental health disorders like depression and epilepsy. This enabled us to learn how a new instrument to measure mental function becomes constructed and what translations take place in this process. Here we pay particular attention to the role of patients as research collaborators. We observed the frictions and debates in the research team between different mental health knowledge regimes, seeing them before they were black-boxed and lost from sight. We aimed to understand how actors anticipate software and data analytics to function alongside physicians and patients, as well as how different accounts reconstitute the 'mental', 'therapy', or the 'social' itself. We discuss several 'dissociations' that occur along the research trajectory regarding: less motivated and underrepresented patients, the role of clinical knowledge derived from patient self-reporting, and the social, political, and economic aspects of a patient's life affecting mental health. In this sense, we want to open the black box of this new behavioral technoscience.

Digital Biomarkers in Psychiatric Research: Data Protection Qualifications in a Complex Ecosystem

Psychiatric research traditionally relies on subjective observation, which is time-consuming and labor-intensive. The widespread use of digital devices, such as smartphones and wearables, enables the collection and use of vast amounts of user-generated data as "digital biomarkers." These tools may also support increased participation of psychiatric patients in research and, as a result, the production of research results that are meaningful to them. However, sharing mental health data and research results may expose patients to discrimination and stigma risks, thus discouraging participation. To earn and maintain participants' trust, the first essential requirement is to implement an appropriate data governance system with a clear and transparent allocation of data protection duties and responsibilities among the actors involved in the process. These include sponsors, investigators, operators of digital tools, as well as healthcare service providers and biobanks/databanks. While previous works have proposed practical solutions to this end, there is a lack of consideration of positive data protection law issues in the extant literature. To start filling this gap, this paper discusses the GDPR legal qualifications of controller, processor, and joint controllers in the complex ecosystem unfolded by the integration of digital biomarkers in psychiatric research, considering their implications and proposing some general practical recommendations.