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Study finds link between air pollution and increased depression symptoms in people with bipolar disorder
[December 06, 2022]

Study finds link between air pollution and increased depression symptoms in people with bipolar disorder

Study is the first to make use of a digital health app and geolocation data from mobile phones to associate users' clinical symptoms with pollution data

BOSTON, Dec. 6, 2022 /PRNewswire/ -- Researchers at University College London (UCL) published the results of the first study to find that short-term air pollution exposure is associated with acutely increased depression symptoms in people with bipolar disorder.

The study, "Real-time air pollution and bipolar disorder symptoms: a remote monitored cross-sectional study," is the first to compare daily air quality index (AQI) data with patients' scores on clinical-grade surveys of depression and mania. Data were generated over a two-week period from the mobile phones of 1,432 people diagnosed with bipolar disorder who use juli, the digital health platform for chronic conditions. The study found that as air quality worsened, symptoms of depression increased. The effect was statistically significant; a 23-point increase in AQIi (equal to one standard deviation) was associated with a quarter of a point increase on the Patient Health Questionnaire (PHQ-8), a standard masure of depressive symptoms. No association was found between air quality and mania symptoms.

"Previous studies have found that air pollutants potentially play a role in mental health problems via neurotoxicity, neuroinflammation and hormonal dysregulation," said the study's senior author, Joseph Hayes, MD, PhD, Principal Research Fellow at UCL and co-founder of juli. "This study suggests that air pollution may represent an important modifiable risk factor for symptom severity in a range of mental health problems including bipolar disorder." 

juli engages consumers to power their own health while offering their healthcare providers insights from sub-episodic health data. It helps people manage not only bipolar disorder but chronic conditions like depression, migraine, asthma, hypertension and chronic pain. 

The juli platform does this by aggregating and analyzing data from electronic medical records, smartphones, wearable devices and the environment, as well as patient responses to 3-5 daily questions and bi-weekly clinically validated, disease-specific questionnaires. juli then suggests personalized micro-behavioral changes to help alleviate symptoms of the conditions, and adjusts suggestions based on how users respond. 

The current pollution study was generated by gathering data from the PHQ-8 and one other standard screening and diagnostic questionnaireii presented within the juli app. Both questionnaires are commonly used in outpatient settings that are designed to assess the presence and severity of manic symptoms and depression. The use of mobile phone geolocation technology minimized the risk that exposure to air pollution would be miscalculated, which may have been an issue with previous studies of air pollution and mental health. 

"People with bipolar disorder need to carefully manage their daily lives to avoid the uncomfortable mood swings that come with the condition. This new information gives them another lever to help them maintain an even keel," said Bettina Hein, juli's CEO and co-Founder. "Following our previous study, which found that the use of juli can sharply reduce mania symptoms in over 50% of users, this new study is good news for people who suffer from this lifelong debilitating condition."

The full study is available for download at

About juli 

juli is an AI-driven next-gen chronic condition management platform for multi-factorial and comorbid conditions, currently covering asthma, migraine, chronic pain, hypertension, depression and bipolar disorder.

Patients and their care teams that use juli can track their conditions easily, understand triggers and get recommendations on how to get better or avoid the next episode. This empowers patients to take an active role in managing their condition and improving their outcomes, helping providers, health systems, insurers and employers lower costs. Care teams access juli data within their normal workflows through the app's seamless FHIR-based integration with electronic health records.

Media Contact:

Todd Stein
[email protected]

i The AQI ranges from 0-500, with higher scores reflecting worse pollution. AQI includes particulate matter, nitrogen dioxide, sulphur dioxide, ozone, and carbon monoxide. For each pollutant, an AQI value of 100 generally corresponds to an ambient air concentration that equals the level of the short-term national ambient air quality standard for the protection of public health. AQI values at or below 100 are satisfactory and values over 100 are unhealthy.
ii The Altman Self-Rating Mania Scale (ASRM) is a tool commonly used in the outpatient setting to measure symptoms of mania/hypomania, and the Patient Health Questionnaire (PHQ-8) measures depressive symptoms.

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