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Keywords = biosignal-based anxiety assessment

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33 pages, 1529 KB  
Review
Smart Devices and Multimodal Systems for Mental Health Monitoring: From Theory to Application
by Andreea Violeta Caragață, Mihaela Hnatiuc, Oana Geman, Simona Halunga, Adrian Tulbure and Catalin J. Iov
Bioengineering 2026, 13(2), 165; https://doi.org/10.3390/bioengineering13020165 - 29 Jan 2026
Cited by 4 | Viewed by 2816
Abstract
Smart devices and multimodal biosignal systems, including electroencephalography (EEG/MEG), ECG-derived heart rate variability (HRV), and electromyography (EMG), increasingly supported by artificial intelligence (AI), are being explored to improve the assessment and longitudinal monitoring of mental health conditions. Despite rapid growth, the available evidence [...] Read more.
Smart devices and multimodal biosignal systems, including electroencephalography (EEG/MEG), ECG-derived heart rate variability (HRV), and electromyography (EMG), increasingly supported by artificial intelligence (AI), are being explored to improve the assessment and longitudinal monitoring of mental health conditions. Despite rapid growth, the available evidence remains heterogeneous, and clinical translation is limited by variability in acquisition protocols, analytical pipelines, and validation quality. This systematic review synthesizes current applications, signal-processing approaches, and methodological limitations of biosignal-based smart systems for mental health monitoring. Methods: A PRISMA 2020-guided systematic review was conducted across PubMed/MEDLINE, Scopus, the Web of Science Core Collection, IEEE Xplore, and the ACM Digital Library for studies published between 2013 and 2026. Eligible records reported human applications of wearable/smart devices or multimodal biosignals (e.g., EEG/MEG, ECG/HRV, EMG, EDA/GSR, and sleep/activity) for the detection, monitoring, or management of mental health outcomes. The reviewed literature after predefined inclusion/exclusion criteria clustered into six themes: depression detection and monitoring (37%), stress/anxiety management (18%), post-traumatic stress disorder (PTSD)/trauma (5%), technological innovations for monitoring (25%), brain-state-dependent stimulation/interventions (3%), and socioeconomic context (7%). Across modalities, common analytical pipelines included artifact suppression, feature extraction (time/frequency/nonlinear indices such as entropy and complexity), and machine learning/deep learning models (e.g., SVM, random forests, CNNs, and transformers) for classification or prediction. However, 67% of studies involved sample sizes below 100 participants, limited ecological validity, and lacked external validation; heterogeneity in protocols and outcomes constrained comparability. Conclusions: Overall, multimodal systems demonstrate strong potential to augment conventional mental health assessment, particularly via wearable cardiac metrics and passive sensing approaches, but current evidence is dominated by proof-of-concept studies. Future work should prioritize standardized reporting, rigorous validation in diverse real-world cohorts, transparent model evaluations, and ethics-by-design principles (privacy, fairness, and clinical governance) to support translation into practice. Full article
(This article belongs to the Special Issue IoT Technology in Bioengineering Applications: Second Edition)
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9 pages, 1082 KB  
Article
Heart and Breathing Rate Variations as Biomarkers for Anxiety Detection
by Florian Ritsert, Mohamed Elgendi, Valeria Galli and Carlo Menon
Bioengineering 2022, 9(11), 711; https://doi.org/10.3390/bioengineering9110711 - 19 Nov 2022
Cited by 45 | Viewed by 8417
Abstract
With advances in portable and wearable devices, it should be possible to analyze and interpret the collected biosignals from those devices to tailor a psychological intervention to help patients. This study focuses on detecting anxiety by using a portable device that collects electrocardiogram [...] Read more.
With advances in portable and wearable devices, it should be possible to analyze and interpret the collected biosignals from those devices to tailor a psychological intervention to help patients. This study focuses on detecting anxiety by using a portable device that collects electrocardiogram (ECG) and respiration (RSP) signals. The feature extraction focused on heart-rate variability (HRV) and breathing-rate variability (BRV). We show that a significant change in these signals occurred between the non-anxiety-induced and anxiety-induced states. The HRV biomarkers were the mean heart rate (MHR; p¯ = 0.04), the standard deviation of the heart rate (SD; p¯ = 0.01), and the standard deviation of NN intervals (SDNN; p¯ = 0.03) for ECG signals, and the mean breath rate (MBR; p¯ = 0.002), the standard deviation of the breath rate (SD; p¯ < 0.0001), the root mean square of successive differences (RMSSD; p¯ < 0.0001) and SDNN (p¯ < 0.0001) for RSP signals. This work extends the existing literature on the relationship between stress and HRV/BRV by being the first to introduce a transitional phase. It contributes to systematically processing mental and emotional impulse data in humans measured via ECG and RSP signals. On the basis of these identified biomarkers, artificial-intelligence or machine-learning algorithms, and rule-based classification, the automated biosignal-based psychological assessment of patients could be within reach. This creates a broad basis for detecting and evaluating psychological abnormalities in individuals upon which future psychological treatment methods could be built using portable and wearable devices. Full article
(This article belongs to the Special Issue Advances of Biomedical Signal Processing)
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12 pages, 1523 KB  
Data Descriptor
Dataset of Psychological Scales and Physiological Signals Collected for Anxiety Assessment Using a Portable Device
by Mohamed Elgendi, Valeria Galli, Chakaveh Ahmadizadeh and Carlo Menon
Data 2022, 7(9), 132; https://doi.org/10.3390/data7090132 - 14 Sep 2022
Cited by 29 | Viewed by 14226
Abstract
Portable and wearable devices are becoming increasingly common in our daily lives. In this study, we examined the impact of anxiety-inducing videos on biosignals, particularly electrocardiogram (ECG) and respiration (RES) signals, that were collected using a portable device. Two psychological scales (Beck Anxiety [...] Read more.
Portable and wearable devices are becoming increasingly common in our daily lives. In this study, we examined the impact of anxiety-inducing videos on biosignals, particularly electrocardiogram (ECG) and respiration (RES) signals, that were collected using a portable device. Two psychological scales (Beck Anxiety Inventory and Hamilton Anxiety Rating Scale) were used to assess overall anxiety before induction. The data were collected at Simon Fraser University from participants aged 18–56, all of whom were healthy at the time. The ECG and RES signals were collected simultaneously while participants continuously watched video clips that stimulated anxiety-inducing (negative experience) and non-anxiety-inducing events (positive experience). The ECG and RES signals were recorded simultaneously at 500 Hz. The final dataset consisted of psychological scores and physiological signals from 19 participants (14 males and 5 females) who watched eight video clips. This dataset can be used to explore the instantaneous relationship between ECG and RES waveforms and anxiety-inducing video clips to uncover and evaluate the latent characteristic information contained in these biosignals. Full article
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