ABSTRACT
Background: Empty Nest Syndrome (ENS) is a complex grief state, observed in the affected parents when their children leave home. Studies show ENS may progress to clinical-grade depression and anxiety if left uncared for. Methodology: In this double-blind case-control cross-sectional study, 80 subjects are recruited by a panel of psychologists and psychiatrists. Subjects are divided into two equal groups – case (with ENS symptoms) and control (without symptoms). Three instruments are applied – a) ENS interpretation by the psychologists based on the symptoms, b) Lyfas smartphone-based biomedical application to capture the cardiovascular optical biomarkers (COB) from the index finger non-invasively with the help of arterial photoplethysmography technique, and c) Hamilton’s depression scales (HAM-D), which psychiatrists have used to check the mental health of the subjects. The COB (e.g., SD1/SD2, LF/HF, HRVScore, and ENERGY) and a set of physical parameters (e.g., Body mass index or BMI, Heart rate or HR, Systolic blood pressure or SBP, Diastolic blood pressure or DBP, Glycosylated hemoglobin or HbA1c, Cholesterol, Triglyceride, Thyroid-stimulating hormone or TSH, Estradiol or E2, and Testosterone or TST) consist the independent variables, while ENS scores interpreted by the psychologists and HAM-D scores interpreted by the psychiatrists are the dependent variables. Spearman’s rank correlation and Bland Altman’s reliability tests are performed to mine the significant independent variables and reliability of Lyfas ENS (LENS) application. Results: The study observes that SD1/SD2, LF/HF, HRVScore, ENERGY, DBP, BMI, HR, HbA1c, TSH, and Estradiol have significant roles in ENS. Bland Altman's reliability measure shows that LENS (novel instrument under trial) has a high agreement of 92.85% and 93.86%, respectively with ENS scoring done by senior psychologists (champion instrument1) and HAM-D grading performed by psychiatrists (champion instrument2). Conclusions: LENS can be used as a clinical-graded pocket application for screening and monitoring ENS.