Automatically Generated Smartphone Data in Young Patients With Newly Diagnosed Bipolar Disorder and Healthy Controls

Background: Smartphones may facilitate continuous and fine-grained monitoring of behavioral activities via automatically generated data and could prove to be especially valuable in monitoring illness activity in young patients with bipolar disorder (BD), who often present with rapid changes in mood and related symptoms. The present pilot study in young patients with newly diagnosed BD and healthy controls (HC) aimed to (1) validate automatically generated smartphone data reflecting physical and social activity and phone usage against validated clinical rating scales and questionnaires; (2) investigate differences in automatically generated smartphone data between young patients with newly diagnosed BD and HC; and (3) investigate associations between automatically generated smartphone data and smartphone-based self-monitored mood and activity in young patients with newly diagnosed BD.Methods: A total of 40 young patients with newly diagnosed BD and 21 HC aged 15–25 years provided daily automatically generated smartphone data for 3–779 days [median (IQR) = 140 (11.5–268.5)], in addition to daily smartphone-based self-monitoring of activity and mood. All participants were assessed with clinical rating scales.Results: (1) The number of outgoing phone calls was positively associated with scores on the Young Mania Rating Scale and subitems concerning activity and speech. The number of missed calls (p = 0.015) and the number of outgoing text messages (p = 0.017) were positively associated with the level of psychomotor agitation according to the Hamilton Depression Rating scale subitem 9. (2) Young patients with newly diagnosed BD had a higher number of incoming calls compared with HC (BD: mean = 1.419, 95% CI: 1.162, 1.677; HC: mean = 0.972, 95% CI: 0.637, 1.308; p = 0.043) and lower self-monitored mood and activity (p's < 0.001). (3) Smartphone-based self-monitored mood and activity were positively associated with step counts and the number of outgoing calls, respectively (p's < 0.001).Conclusion: Automatically generated data on physical and social activity and phone usage seem to reflect symptoms. These data differ between young patients with newly diagnosed BD and HC and reflect changes in illness activity in young patients with BD. Automatically generated smartphone-based data could be a useful clinical tool in diagnosing and monitoring illness activity in young patients with BD.

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Smartphone-based activity measurements in patients with newly diagnosed bipolar disorder, unaffected relatives and control individuals

International Journal of Bipolar Disorders ◽

10.1186/s40345-020-00195-0 ◽

2020 ◽

Vol 8 (1) ◽

Author(s):

Sharleny Stanislaus ◽

Maj Vinberg ◽

Sigurd Melbye ◽

Mads Frost ◽

Jonas Busk ◽

...

Keyword(s):

Physical Activity ◽

Bipolar Disorder ◽

Rating Scales ◽

Rating Scale ◽

Social Activity ◽

Activity Level ◽

Activity Levels ◽

Young Mania ◽

Activity Measurements ◽

Activity Questionnaire

Abstract Background In DSM-5 activity is a core criterion for diagnosing hypomania and mania. However, there are no guidelines for quantifying changes in activity. The objectives of the study were (1) to investigate daily smartphone-based self-reported and automatically-generated activity, respectively, against validated measurements of activity; (2) to validate daily smartphone-based self-reported activity and automatically-generated activity against each other; (3) to investigate differences in daily self-reported and automatically-generated smartphone-based activity between patients with bipolar disorder (BD), unaffected relatives (UR) and healthy control individuals (HC). Methods A total of 203 patients with BD, 54 UR, and 109 HC were included. On a smartphone-based app, the participants daily reported their activity level on a scale from −3 to + 3. Additionally, participants owning an android smartphone provided automatically-generated data, including step counts, screen on/off logs, and call- and text-logs. Smartphone-based activity was validated against an activity questionnaire the International Physical Activity Questionnaire (IPAQ) and activity items on observer-based rating scales of depression using the Hamilton Depression Rating scale (HAMD), mania using Young Mania Rating scale (YMRS) and functioning using the Functional Assessment Short Test (FAST). In these analyses, we calculated averages of smartphone-based activity measurements reported in the period corresponding to the days assessed by the questionnaires and rating scales. Results (1) Smartphone-based self-reported activity was a valid measure according to scores on the IPAQ and activity items on the HAMD and YMRS, and was associated with FAST scores, whereas the majority of automatically-generated smartphone-based activity measurements were not. (2) Daily smartphone-based self-reported and automatically-generated activity correlated with each other with nearly all measurements. (3) Patients with BD had decreased daily self-reported activity compared with HC. Patients with BD had decreased physical (number of steps) and social activity (more missed calls) but a longer call duration compared with HC. UR also had decreased physical activity compared with HC but did not differ on daily self-reported activity or social activity. Conclusion Daily self-reported activity measured via smartphone represents overall activity and correlates with measurements of automatically generated smartphone-based activity. Detecting activity levels using smartphones may be clinically helpful in diagnosis and illness monitoring in patients with bipolar disorder. Trial registration clinicaltrials.gov NCT02888262

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Comparisons of Narrative Psychotherapy to Conventional CBT for the Psychotherapy of Psychosis and Bipolar Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1480 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s779-s779

Author(s):

L. Mehl-Madrona ◽

B. Mainguy

Keyword(s):

Bipolar Disorder ◽

Narrative Therapy ◽

Rating Scales ◽

Psychotic Disorders ◽

Rating Scale ◽

Therapy Group ◽

Well Being ◽

Outcome Data ◽

Symptom Scale ◽

Young Mania

IntroductionThere is ongoing debate about about both the value of psychotherapy in psychotic disorders and the best type of psychotherapy to use if necessary.MethodsWe conducted narrative psychotherapy with 18 adults, all diagnosed as having bipolar disorder with psychotic features and/or schizo-affective disorder. Outcome data consisted of the Positive and Negative Symptom Scale, the Clinical Global Impressions Scale, the Young Mania Rating Scale, the Hamilton Anxiety and Depression Scales, the My Medical Outcome Profile, Version 2(MYMOP2), and the Outcome Rating Scales of Duncan and Miller. We compare the outcomes of our patients to those of a matched comparison group receiving conventional psycho-education and cognitive behavioural therapy. Patients were seen for a minimum of 16 weeks over an average of 22 weeks. Average age was 31.5 years with a standard deviation of 8.1 years.ResultsThe narrative therapy group showed statistically significant reductions in all outcome measures compared to the conventional treatment group. They continued treatment significantly longer and had fewer re-hospitalizations. They were less distressed by voices.ConclusionsA narrative psychotherapy approach using dialogical theory and therapy ideas is a reasonable approach for the psychotherapy of psychosis. Review of psychotherapy notes showed that narrative approaches allowed the therapist to align with the patient as collaborator in considering the story presented and was therefore less productive of defensiveness and self-criticism than conventional approaches. The therapy included techniques for negotiating changes in illness narratives, identity narratives, and treatment narratives that were more conducive of well-being and recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Lower plasma soluble TWEAK concentration in patients with newly diagnosed hypertension

Clinical & Investigative Medicine ◽

10.25011/cim.v35i1.16102 ◽

2012 ◽

Vol 35 (1) ◽

pp. 20 ◽

Cited By ~ 6

Author(s):

Nuri Karadurmus ◽

Serkan Tapan ◽

Mustafa Cakar ◽

Ilkin Naharci ◽

Turgay Celik ◽

...

Keyword(s):

Blood Pressure ◽

Treatment Options ◽

Young Patients ◽

Serum Levels ◽

Young Group ◽

Healthy Controls ◽

Newly Diagnosed ◽

Plasma Adma ◽

Dimethyl Arginine ◽

Circulating Levels

Purpose: To determine circulating levels of the soluble TNF-like weak inducer of apoptosis (sTWEAK)and its association with demographic and biochemical parameters in a young group of patients with newly diagnosed and never treated hypertension. Methods: A total of 51 patients (mean age 21.7 ±1.4 years, body mass index (BMI) 24.5 ±1.6 kg/m2) with primary untreated hypertension, and 37 age- and BMI-matched healthy controls (mean age 22.5 ± 1.9 years, BMI 24.7 ± 1.5 kg/m2) were studied. Serums TWEAK and plasma asymmetrical dimethyl arginine (ADMA) levels were measured by EIA. Results: In patients and controls, mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 149.8±5.65/93.4±3.4 mmHg and 124.2±6.4/78.24±5.5 mmHg, respectively. Serum sTWEAK levels were lower in the patient group (882.6±228.9 μmol/L vs. 1060.2±231.7μmol/L, p=0.001), whereas plasma ADMA levels werehigher(0.837±0.34μmol/L vs.0.3176±0.25μmol/L, p < 0.001). sTWEAK serum levels correlated with SBP(r=-0.301; p=0.005) and DBP (r=-0.279; p=0.009). Circulating plasma ADMA levels also correlated with SBP (r=0.734; p < 0.001) and DBP (r=0.733; p < 0.001). Conclusion: Young patients with yet untreated primary hypertension have lower circulating serum sTWEAK level compared with healthy controls. Further research for possible associations among serum sTWEAK, endothelial dysfunction and other measures of atherosclerosis may be of benefit in order to better understand the pathophysiology of hypertension and to establish more effective treatment options.

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Brain-derived neurotrophic factor levels in newly diagnosed patients with bipolar disorder, their unaffected first-degree relatives and healthy controls

BJPsych Open ◽

10.1192/bjo.2021.9 ◽

2021 ◽

Vol 7 (2) ◽

Author(s):

Nanna Aagaard Petersen ◽

Marc Østergaard Nielsen ◽

Klara Coello ◽

Sharleny Stanislaus ◽

Sigurd Melbye ◽

...

Keyword(s):

Bipolar Disorder ◽

Neurotrophic Factor ◽

Brain Derived Neurotrophic Factor ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Controls ◽

Newly Diagnosed ◽

First Degree Relatives ◽

Duration Of Illness ◽

And Gender ◽

Medication Status

Background Brain-derived neurotrophic factor (BDNF), which facilitates neuroplasticity and synaptogenesis, may be decreased in bipolar disorder, but has not been systematically investigated in people with newly diagnosed bipolar disorder and unaffected first-degree relatives. Aims To compare BDNF levels in patients with newly diagnosed bipolar disorder, their unaffected first-degree relatives and healthy controls. Method The study investigated plasma BDNF levels in patients (n = 371) with newly diagnosed bipolar disorder, their unaffected first-degree relatives (n = 98) and healthy controls (n = 200) using enzyme-linked immunosorbent assay. We further investigated associations between BDNF levels and illness-related variables and medication status. Results BDNF levels were found to be 22.0% (95% CI 1.107–1.343) higher in patients with bipolar disorder compared with healthy controls (P < 0.001) and 15.6% higher in unaffected first-degree relatives compared with healthy controls (95% CI 1.007–1.327, P = 0.04), when adjusting for age and gender. Further, BDNF levels were positively associated with duration of illness at a trend level (P = 0.05), age (P = 0.001) and use of anti-epileptic medication (P = 0.05). Conclusions These findings suggest that BDNF levels are not decreased in the early stages of bipolar disorder and in unaffected first-degree relatives contrasting with prior findings during later stages of the illness.

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Exploring Movement Impairments in Patients With Parkinson's Disease Using the Microsoft Kinect Sensor: A Feasibility Study

Frontiers in Neurology ◽

10.3389/fneur.2020.610614 ◽

2021 ◽

Vol 11 ◽

Author(s):

Ditte Rudå ◽

Gudmundur Einarsson ◽

Anne Sofie Schott Andersen ◽

Jannik Boll Matthiassen ◽

Christoph U. Correll ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Performance ◽

Rating Scales ◽

Rating Scale ◽

Motor Task ◽

Microsoft Kinect ◽

Healthy Controls ◽

Kinect Sensor ◽

Microsoft Kinect Sensor

Background: Current assessments of motor symptoms in Parkinson's disease are often limited to clinical rating scales.Objectives: To develop a computer application using the Microsoft Kinect sensor to assess performance-related bradykinesia.Methods: The developed application (Motorgame) was tested in patients with Parkinson's disease and healthy controls. Participants were assessed with the Movement Disorder Society Unified Parkinson's disease Rating Scale (MDS-UPDRS) and standardized clinical side effect rating scales, i.e., UKU Side Effect Rating Scale and Simpson-Angus Scale. Additionally, tests of information processing (Symbol Coding Task) and motor speed (Token Motor Task), together with a questionnaire, were applied.Results: Thirty patients with Parkinson's disease and 33 healthy controls were assessed. In the patient group, there was a statistically significant (p < 0.05) association between prolonged time of motor performance in the Motorgame and upper body rigidity and bradykinesia (MDS-UPDRS) with the strongest effects in the right hand (p < 0.001). In the entire group, prolonged time of motor performance was significantly associated with higher Simson-Angus scale rigidity score and higher UKU hypokinesia scores (p < 0.05). A shortened time of motor performance was significantly associated with higher scores on information processing (p < 0.05). Time of motor performance was not significantly associated with Token Motor Task, duration of illness, or hours of daily physical activity. The Motorgame was well-accepted.Conclusions: In the present feasibility study the Motorgame was able to detect common motor symptoms in Parkinson's disease in a statistically significant and clinically meaningful way, making it applicable for further testing in larger samples.

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Motor activity patterns can distinguish between interepisode bipolar disorder patients and healthy controls

CNS Spectrums ◽

10.1017/s1092852920001777 ◽

2020 ◽

pp. 1-11

Author(s):

Jakub Schneider ◽

Eduard Bakštein ◽

Marian Kolenič ◽

Pavel Vostatek ◽

Christoph U. Correll ◽

...

Keyword(s):

Bipolar Disorder ◽

Motor Activity ◽

Employment Status ◽

Rating Scale ◽

Activity Patterns ◽

Healthy Controls ◽

Respective Group ◽

Young Mania ◽

Mean Values ◽

Time Variations

Abstract Background Bipolar disorder (BD) is linked to circadian rhythm disruptions resulting in aberrant motor activity patterns. We aimed to explore whether motor activity alone, as assessed by longitudinal actigraphy, can be used to classify accurately BD patients and healthy controls (HCs) into their respective groups. Methods Ninety-day actigraphy records from 25 interepisode BD patients (ie, Montgomery–Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) < 15) and 25 sex- and age-matched HCs were used in order to identify latent actigraphic biomarkers capable of discriminating between BD patients and HCs. Mean values and time variations of a set of standard actigraphy features were analyzed and further validated using the random forest classifier. Results Using all actigraphy features, this method correctly assigned 88% (sensitivity = 85%, specificity = 91%) of BD patients and HCs to their respective group. The classification success may be confounded by differences in employment between BD patients and HCs. When motor activity features resistant to the employment status were used (the strongest feature being time variation of intradaily variability, Cohen’s d = 1.33), 79% of the subjects (sensitivity = 76%, specificity = 81%) were correctly classified. Conclusion A machine-learning actigraphy-based model was capable of distinguishing between interepisode BD patients and HCs solely on the basis of motor activity. The classification remained valid even when features influenced by employment status were omitted. The findings suggest that temporal variability of actigraphic parameters may provide discriminative power for differentiating between BD patients and HCs while being less affected by employment status.

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Validation of a Spanish Version of the Lille Apathy Rating Scale for Parkinson’s Disease

The Scientific World JOURNAL ◽

10.1155/2014/849834 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Rocio García-Ramos ◽

Clara Villanueva Iza ◽

María José Catalán ◽

Abilio Reig-Ferrer ◽

Jorge Matías-Guíu

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Interrater Reliability ◽

Rating Scales ◽

Rating Scale ◽

Reliability And Validity ◽

Spanish Version ◽

Healthy Controls ◽

Lars Score ◽

Optimal Cutoff Point

Introduction. To date, no rating scales for detecting apathy in Parkinson’s disease (PD) patients have been validated in Spanish. For this reason, the aim of this study was to validate a Spanish version of Lille apathy rating scale (LARS) in a cohort of PD patients from Spain.Participants and Methods. 130 PD patients and 70 healthy controls were recruited to participate in the study. Apathy was measured using the Spanish version of LARS and the neuropsychiatric inventory (NPI). Reliability (internal consistency, test-retest, and interrater reliability) and validity (construct, content, and criterion validity) were measured.Results. Interrater reliability was 0.93. Cronbach’sαfor LARS was 0.81. The test-retest correlation coefficient was 0.97. The correlation between LARS and NPI scores was 0.61. The optimal cutoff point under the ROC curve was-14, whereas the value derived from healthy controls was-11. The prevalence of apathy in our population tested by LARS was 42%.Conclusions. The Spanish version of LARS is a reliable and useful tool for diagnosing apathy in PD patients. Total LARS score is influenced by the presence of depression and cognitive impairment. However, both disorders are independent identities with respect to apathy. The satisfactory reliability and validity of the scale make it an appropriate instrument for screening and diagnosing apathy in clinical practice or for research purposes.

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Mood, activity, and sleep measured via daily smartphone-based self-monitoring in young patients with newly diagnosed bipolar disorder, their unaffected relatives and healthy control individuals

European Child & Adolescent Psychiatry ◽

10.1007/s00787-020-01611-7 ◽

2020 ◽

Author(s):

Sigurd Arne Melbye ◽

Sharleny Stanislaus ◽

Maj Vinberg ◽

Mads Frost ◽

Jakob Eyvind Bardram ◽

...

Keyword(s):

Bipolar Disorder ◽

Young Patients ◽

Newly Diagnosed ◽

Self Monitoring ◽

Healthy Control

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Using accelerometer as a diagnostic tool to detect drug-induced parkinsonism (DIP) secondary to first-generation anti-psychotic medications

Australasian Psychiatry ◽

10.1177/1039856220901467 ◽

2020 ◽

Vol 28 (3) ◽

pp. 348-353 ◽

Cited By ~ 3

Author(s):

Roth Trisno ◽

Parvathy Nair ◽

Daniel Martin ◽

Maryam S Baghini ◽

Hoam Chung ◽

...

Keyword(s):

First Generation ◽

Rating Scales ◽

Rating Scale ◽

Controlled Clinical Trial ◽

Drug Induced ◽

Clinical Rating ◽

Disease Rating ◽

Movement Disorder Society ◽

Better Than ◽

Clinical Rating Scale

Objective: The objective of this study is to examine the effectiveness of an accelerometer-based compact system in detecting and quantifying drug-induced parkinsonism (DIP) in patients with schizophrenia. Method: A pilot study controlled clinical trial comprising 6 people with schizophrenia and 11 control subjects was conducted at Alfred Health, Melbourne. Participants had their movements assessed using Barnes Akathisia Rating Scale (BARS), Simpson Angus Scale (SAS) and Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III) followed by an assessment of gait using three triaxial accelerometers. Results: Median BARS, SAS, MDS-UPDRS III and accelerometer scores were significantly higher for patients with schizophrenia than controls. Accelerometers detected three times more rest tremor than clinical rating scales. Patients with schizophrenia had 70% of their dynamic acceleration at frequencies between 4 and 10 Hz, which is almost twice that observed in the control population (38%). Accelerometer scores were significantly correlated with BARS scores. Conclusion: Accelerometers were able to accurately detect patients with DIP better than some clinical rating scale including the SAS. Further larger-scale studies must be conducted to further demonstrate the accuracy of accelerometers in detecting DIP.

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