Smartphone for Mental Health Patients: A Double-edged Weapon?

IntroductionThe current development of new technologies dedicated to healthcare, such as smartphones, provides an interesting opportunity to improve both assessment and follow-up of different illnesses, particularly mental diseases.AimTo investigate, the contributions and risks of smartphone use among mental health patients.MethodsWe conducted a literature research of PubMed and Sciencedirect using the key words “smartphone”; “bipolar disorder”; “schizophrenia”; “anxiety disorders”; “addiction”; “dementia”.ResultsLiterature data provide several examples of the use of the smartphone's features for patient monitoring. One such example involved patients with Alzheimer disease. An attempt to deal with the risk of wandering was proposed with the use of the Android app iWander, which works by using the smartphone's GPS to track the patient at all times. As for bipolar disorder, several applications have been proposed both for diagnostic ic instruments…) and interventional purposes (applications that offer subjects psycho-education in the form of emotional self-awareness…). Several other applications can be used in the management of schizophrenia, social anxiety disorder and addictions. Along with its obvious benefits, however, the smartphone use has a dark side. Problematic smartphone use is one form of behavioral addiction recently identified. In addition, the access to Internet through the smartphone opens the door to Internet addiction and its sub-types (cybersexual addiction, cyber-relationship addiction…).ConclusionThe use of smartphone for medical purposes must be cautious among mental health patients, because of a field of vulnerability that promotes the appearance of other mental diseases, especially addictions, which may darken their prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The acceptability of web-care for patients with major depressive disorder

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.848 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S28-S28

Author(s):

M. Ladea ◽

M. Bran

Keyword(s):

Mental Health ◽

Web Application ◽

New Technologies ◽

Depression Scale ◽

Assessment Tools ◽

Online Information ◽

Evaluation Tool ◽

Governmental Organization ◽

Self Evaluation ◽

Competing Interest

IntroductionWith the extraordinary rate of development of E-health and widespread internet access in Romania, Inomedica decided to create a platform dedicated primarily to the patients and their families: depresiv.ro. According to Internet Live Stats there were 11,178,477 Internet users in Romania (representing 51.66% of the population) in 2014. Inomedica is a non-governmental organization founded by a multidisciplinary team (psychiatrists, sociologists, IT specialists).The platforms provide rigorous and quality online information about depression as well as self-assessment tools and Q&A section.The presentation will explore the development and effects of the first 16 months of operation of a web platform about depression.MethodsThe depresiv.ro platform design is simple and user friendly. Mental health specialists contributed to the development of the content, which is easy to access and understand.The platform also provides access to a self-evaluation tool, the Hospital Anxiety and Depression Scale (HADS), and thus helps the users identify possible problems and encourage them to seek professional help. The web application also included a demographic questionnaire, and a medical history questionnaire. A native iOS version of the application is available to download free on AppStore. The platform is supported by a Google grant program.ResultsThe platform traffic increased from a few users per day at launch to more than 1000 unique visitors per day. Since 1st January 2015, about 178,000 unique visitors accessed the platform. All the metrics improved significantly during the last months: bounce rate (66.3%), average session duration (02:17 minutes), number of pages per session (2.4).About 25,000 users accessed the HADS application since its release, from August 2014 until September 2015, showing the increasing need for free online self-evaluation tools.The Q&A section is one of the most visited on the platform since many users try to find answers for their questions regarding depressive or anxiety symptoms.ConclusionsAs new technologies are introduced and become more accessible, mental health specialists are developing new ways of providing services and collecting data. The traffic data/usage for both the depresiv.ro platform and the app are evidence for the widespread acceptability of web-based delivery methods.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The NYMPHA-MD Project: Next Generation Mobile Platforms for Health, in Mental Disorders

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.124 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S23-S23

Author(s):

M. Faurholt-Jepsen

Keyword(s):

Mental Health ◽

Bipolar Disorder ◽

Mental Disorders ◽

New Technologies ◽

Text Messages ◽

Warning Signs ◽

Special Focus ◽

Next Generation ◽

Mobile Platforms ◽

Web Interfaces

Bipolar Disorder is a common and complex mental disorder with a prevalence of 1-2% and accounts as one of the most important causes of disability at age 15-44 years worldwide.Electronic versions of self-monitoring tools and symptom registration using computers, personal digital assistants (PDAs), text messages, and web interfaces have been described in the literature and a large number of commercial Smartphone applications for patients with bipolar disorder are available.The Next Generation Mobile Platforms for Health, in Mental Disorders project (the NYMPHA-MD project), funded by the European Union's Seventh Framework program for research, technological development and demonstration, focuses on the implementation of a Pre-Commercial Procurement of mobile e-health service for supporting physicians and patients in the treatment of bipolar disorder through continuous patients monitoring in order to dynamically support illness management and potentially identify early warning signs.The NYMPHA-MD project will define the framework of a Pre-Commercial Procurement for the provisioning of next generation services advocated for mental health treatment with a special focus on bipolar disorder based on the use of new technologies, open standards and open platforms.The NYMPHA-MD project will focus on identifying requirements involved in the structuring of mental health services with a focus on bipolar disorder treatment including medical, technological, patients, legal, ethical, policy, risk management and business-orientation needs in order to construct a reference model of service provisioning useful in different European contexts.Disclosure of interestThe author has not supplied his declaration of competing interest.

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The importance of establishing a good differential diagnosis in bipolar disorder

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1182 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S338-S338

Author(s):

I. Peñuelas Calvo ◽

J. Sevilla Llewellyn-Jones ◽

C. Cervesi ◽

A. Sareen ◽

A. González Moreno

Keyword(s):

Mental Health ◽

Bipolar Disorder ◽

Personality Disorder ◽

Correct Diagnosis ◽

Unipolar Depression ◽

Health Condition ◽

Diagnostic Process ◽

Negative Consequences ◽

Competing Interest ◽

Disorder Type

Diagnosis plays a key role in identification of a disease, learn about its course, management and predicting prognosis. In mental health, diseases are often complex and coalesce of different symptoms. Diagnosing a mental health condition requires careful evaluation of the symptoms and excluding other differential disorders that may share common symptoms. Diagnose hastily can lead to misdiagnosis. A premature diagnosis or misdiagnosis has clear negative consequences. This is one of the problems related to mental health and one needs to optimize the diagnostic process to achieve a balance between sensitivity and specificity. Currently, the diagnosis of bipolar disorder (BD) is one of the major mental health conditions that is often misdiagnosed.To differentiate BD from unipolar depression with recurrent episodes or with personality disorder (PD), especially type Cluster B – with features shared with mania/hypomania like mental instability or impulsivity, it is important to differentiate between a diagnosis and its comorbidity. BD is often misdiagnosed as personality disorder and vice versa specially when both are coexisting (almost 20% of patients with bipolar disorder type II are misdiagnosed as personality disorders). This is common especially with borderline PD, although in some cases the histrionic PD may also be misdiagnosed as mania.Due to the inconsistency in patient care involving different psychiatrists combined with difficulty in obtaining a precise patient history and family history leads to loss of key information which in turn leads to misdiagnosis of the condition. The time delay in making the correct diagnosis cause by such inconsistencies may worsen the prognosis of the disease in the patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Mental health and drug

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1138 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S328-S328

Author(s):

R. Alonso Díaz ◽

E. Cortázar Alonso ◽

H. Guillén Rodrigo

Keyword(s):

Mental Health ◽

Bipolar Disorder ◽

Therapeutic Response ◽

Manic Episode ◽

Total Sample ◽

Epidemiological Studies ◽

High Prevalence ◽

Addiction Service ◽

Competing Interest ◽

Provincial Center

IntroductionBipolar disorder (BD) is often associated with various comorbidities. It is substance use disorders (SUD) one of the most frequent comorbidities.The ECA study (Epidemiologic Catchment Area) observed a prevalence over the life of the 56, 1% for any TUS in the total sample of patients with bipolar disorder. In subjects with bipolar I disorder prevalence was 60.7%, and those of type II 48.1.In the OMS study conducted in America, Europe and Asia, the results confirm the high rates of disorders in patients diagnosed with bipolar disorder regardless of the country of study.CaseThis is a male, 32, who came first to the Provincial Drug Addiction Service of Huelva in 2009 for cocaine, cannabis and alcohol.In his personal history, he relates a convulsive episode at 14 years and one manic episode associated with consumption of cocaine in 2002 which began to be treated by a team of Mental Health and Provincial Center for Addictions.He entered twice in a therapeutic community in 2009 for treatment for their disorder dependence on cocaine, alcohol and cannabis.It has required admission to the Unit Hospitalization twice in 2012, with the discharge diagnosis of manic episode secondary to drug consumption.ConclusionsMost epidemiological studies in recent decades note the high prevalence of comorbidity BD + SUD.BD-SUD comorbidity is particularly complex because each disorder affects the evolution of the other and they are frequently multiple comorbidities. In addition, it implies a worse clinical and functional outcome as well as poorer therapeutic response.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Interim results of remotely provided, one-on-one, tailored psycho-education and skills training to caregivers of patients with mental health difficulties

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.755 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s281-s282

Author(s):

K. Ashcroft ◽

B. Insua-Summerhays

Keyword(s):

Mental Health ◽

General Health Questionnaire ◽

Skills Training ◽

Well Being ◽

Limited Resources ◽

Training Intervention ◽

The Past ◽

Mental Health Patients ◽

Mental Health Difficulties ◽

Competing Interest

In the past several decades, considerable evidence has emerged on the efficacy of caregiver and family interventions in the treatment of severe and enduring mental health disorders, particularly schizophrenia. Studies have demonstrated benefits of these interventions with regard to both reduced rates of burden in caregivers, and a reduction in relapse and improvement in symptoms of the person with psychosis. However, many caregivers who may benefit from such interventions are unable to access them, due to limited resources and geographical factors. Additionally, concerns about stigma and time constraints may deter caregivers from accessing support. The following study is among the first to address these barriers using a remotely delivered, one-on-one caregiver intervention. Caregivers (n = 93) of patients with severe and enduring mental health difficulties took part in a tailored psychoeducation and skills training intervention, consisting of weekly 40 minute videoconference or telephone sessions with a trained clinician. Caregivers completed the Involvement Evaluation Questionnaire (IEQ) and General Health Questionnaire (GHQ-12) at baseline, and eight sessions (mid treatment). It was hypothesized that caregivers would show a reduction of distress and burden in response to the intervention. Interim comparison of pre- versus 8th session measures demonstrated a highly significant reduction in GHQ scores (P < 001), as well as a highly significant reduction in IEQ scores (P < 001). Results suggest that remotely provided, one-on-one, tailored psycho-education and skills training may be an effective and accessible intervention to improve the well-being of, and decrease burden in, caregivers of mental health patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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New Technologies in Suicide Prevention

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1998 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S148-S149

Author(s):

M. Pompili

Keyword(s):

Mental Health ◽

Suicide Prevention ◽

Mental Health Professionals ◽

Health Professionals ◽

New Technologies ◽

Role Playing ◽

Comprehensive Overview ◽

High Expectations ◽

Vulnerable People ◽

Competing Interest

IntroductionThe use of new technologies is beginning to be embraced by volunteers and professionals, from crisis lines, suicide prevention centers, mental health centers, researchers and politicians.ObjectivesNew technologies have entered the field of suicide prevention with high expectations for the future, despite a relatively slow start. Internet, smartphones, apps, social networks and self-help computer programs have a strong potential to achieve, sustain and help people at risk of suicide, their families, teachers, health professionals and for the survivors.AimsTo provide comprehensive overview on the role of new technologies in suicide prevention.MethodsGiven the relatively early and underdeveloped state of this area of inquiry, the author viewed his task as gathering and critically appraising the available research relevant to the topic, with the aim of formulating a hypothesis to be tested with further research.ResultsNew cheaper services will soon be available to effectively reach and assist the most vulnerable people and prevent suicides. The potential to help vulnerable people who do not use conventional mental health services and people in regions with inadequate psychiatric facilities represents an attractive target with favourable perspectives for suicide prevention Smartphone, apps, websites, avatar coach, and virtual suicidal subjects are important for both delivering help as well as to educate mental health professionals as in the case of role playing.ConclusionsShadows and lights are emerging through the use of new technologies. If more people can be reached there are however concern for improper use of social network and pro-suicide websites.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

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Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800105x ◽

2019 ◽

Vol 42 ◽

Cited By ~ 2

Author(s):

John P. A. Ioannidis

Keyword(s):

Mental Health ◽

Mental Disease ◽

Brain Disorders ◽

Social Stressors ◽

Labor Education ◽

Mental Diseases ◽

Long Term Follow Up ◽

Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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