New research: Can smartphone data be a digital marker for discriminating bipolar disorder from unipolar disorder?

New research: Can smartphone data be a digital marker for discriminating bipolar disorder from unipolar disorder?

by | Apr 13, 2022 | Bipolar, Blog, mHealth

Unipolar disorder (UD) refers to individuals suffering from depression without experiencing mania, whereas individuals suffering from bipolar disorder (BD) usually face episodes of mania in addition to their depression [1]. Clinicians often encounter difficulties identifying whether depressed patients suffer from BD or UD. Given that the course of illness and related treatments vary for patients with BD and UD, the discrimination between these two disorders is critical [2].

A new research paper has just been published on “Differences in mobility patterns according to machine learning models in patients with bipolar disorder and patients with unipolar disorder” in the Journal of Affective Disorders [2].

This new research investigated whether using the information on activity and mobility of patients with BD and UD as supplementary objective measure could assist in the discrimination between the two conditions [2]. Data for this study has been collected as part of the RADMIS trials, two similarly composed randomized controlled trials (RCTs) that investigated the effect of daily smartphone-based monitoring including a clinical feedback loop in individuals suffering from BD and UD. The Monsenso digital health solution was used for the collection of smartphone-based patient data in the intervention group of the trials [3].

The present study included gathering both passively collected smartphone-based location data and patient-reported smartphone-based data on mood from 65 patients with BD and 75 patients with UD [2]. Smartphone-based self-assessments of mood were completed by all patients, and smartphone data on location reflecting mobility patterns, routine and location entropy (chaos) was collected passively from all patients on a continuous basis over the course of six months [2]. The data collection was followed by an extensive data analysis, comparing differences between the two groups.

Results of the study show patients suffering from BD have significantly lower mobility in, e.g., their total time of daily movement during depressive periods (eB 0.74, 95% CI 0.57; 0.97, p = 0.027). Additionally, the area under the curve (AUC) of location data was rather high in classifying patients with BD compared with patients with UD, although results of the study may be limited by relatively low symptom severity of the participating patients contributing to the dimension of the AUC [2].

The study results suggest alterations in location data may be a promising digital diagnostic marker in patients with BD and UD, and smartphone data on mobility patterns could hence help in discriminating between the two disorders. 

Mads Frost, PhD, Co-Founder & Chief Information Security Officer at Monsenso, who has contributed to the research says: “The work on comparing mobility patterns between patients with bipolar disorder and patients with unipolar disorder has been highly interesting, and we look forward to further explore our data looking for potential digital diagnostic markers”.

 “We are excited that Monsenso is a part of promising new research on digital diagnostic markers, and contributes to the research in and the treatment of mental health and neurological disorders”, says Thomas Lethenborg, CEO at Monsenso.

About Monsenso:
Monsenso is an innovative technology company offering a medical grade digital health solution. Our mission is to help provide better mental health to more people at lower costs. Our solution helps optimise the treatment of mental disorders and gives a detailed overview of an individual’s mental health through the collection of outcome, adherence, and behavioural data. It connects individuals, carers, and health care providers to enable personalised treatment, remote care, and early intervention. Based on continuous research and development, our team is committed to developing solutions that fit seamlessly into the lives of individuals, increase their quality of life and improve the efficacy of mental health treatment. To learn more, visit www.monsenso.com

Research publication:
You can find the research publication in the Journal of Affective disorders here.

References:
[1] Quilty, L., Pelletier, M., DeYoung, C.G. & Bagby, M. (2013). Hierarchical personality traits and the distinction between unipolar and bipolar disorders. Journal of Affective Disorders 147(1-3): 247-254. https://www.sciencedirect.com/science/article/pii/S0165032712007604#bib2

[2] Faurholt-Jepsen, M., Busk, J., Rohani D.A., Frost, M. Tønning, M.L., Bardram, J.E. & Kessing, L.V. (2022). Differences in mobility patterns according to machine learning models in patients with bipolar disorder and patients with unipolar disorder. Journal of Affective Disorders 306: 246-253. https://www.sciencedirect.com/science/article/pii/S0165032722003019?dgcid=author

[3] Faurholt-Jepsen, M., Tønning, M.L., Frost, M., Martiny, K., Tuxen, N., Rosenberg, N., Busk, J., Winther, O., Thaysen-Petersen, D., Aamund, K.A. & Tolderlund, L., Bardram, J.E. & Kessing, L.V. (2020). Reducing the rate of psychiatric re-admissions in bipolar disorder using smartphones—The RADMIS trial. Acta Psychiatrica Scandinavia, 143(5): 453-465. https://onlinelibrary.wiley.com/doi/10.1111/acps.13274

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Monsenso provides medication adherence and behavioural monitoring components in H2020 Funded R-LiNK Study

Monsenso provides medication adherence and behavioural monitoring components in H2020 Funded R-LiNK Study

by | Mar 23, 2018 | News

Monsenso’s mHealth solution participates in the R-LiNK Study, a major new study for optimising treatment response to lithium

Copenhagen, Denmark – 16 April 2018  Monsenso is proud to announce our participation in R-LiNK – the major new study for developing a more complete understanding of the reactions and effects of taking lithium. As a part of this study, our solution will be implemented for 300 participants across 15 centres all over Europe.

Lithium is the leading treatment for patients with bipolar disorder. There is a large variability across patient responses when taking lithium. This variability makes it difficult for clinicians to predict how patients will respond to being prescribed lithium.

“Lithium is the oldest drug treatment used regularly in psychiatry and one that has shown evidence of many benefits over the decades it has been used. However, only about one third of patients are “excellent” responders with a future two thirds showing partial or no response. This large EU funded study takes place across Europe and aims to find out which “biomarkers” can be used to predict which patients will respond and for those whom lithium will not help,” said Professor Allan Young, Director of the Centre for Affective Disorders at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London.

R-Link is a multimodal approach to studying lithium initiation, and identifying important biomarkers from receiving lithium treatment. The comprehensive study aims to identify factors related to better responses, safety, and tolerability of lithium treatment. The results of the study can help provide patients and clinicians alike with more accurate information to make informed decisions regarding the prescription of lithium, therefore improving the long term management and prognosis for bipolar patients.

“Mobile health technology can provide new insight into the treatment of mental health and disorders, and mobile phone usage can also provide important new biomarkers for affective disorders.” said Professor Lars Kessing, of the Psychiatric Center Copenhagen and the University of Copenhagen, Faculty of Health Sciences.

The Monsenso mHealth solution will be involved in the phase of the study that will conduct a qualitative and quantitative study on the acceptability and efficacy of connected ecological devices to monitor mood, lithium levels, symptoms, daily behaviour, and enhance patient adherence. Therefore, the solution will include data collection of lithium adherence and outcome/behaviour reporting (via sensor data and daily self-assessment).

“Ensuring adherence to medical treatment on an individual level is key to a successful mental health treatment. Our mHealth solution will contribute to this study by promoting medical adherence, through providing easy, personalised self-monitoring and medication tracking, as well as medication reminders.” said Thomas Lethenborg, CEO of Monsenso.

This study also has the potential to enable the personalisation of lithium based treatment. Findings from this study can also contribute to the overall prevention and reduction of unnecessary side effects from lithium treatment as well as overall ineffective treatments.
Monsenso is now involved in more than ten pan European and domestic research projects in the mental health & affective disorders field.

The study is presently ongoing.

Click here to read the press release in Danish. 

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the grant agreement No.754907. 

Improving the treatment of bipolar disorder with mobile health technology

Improving the treatment of bipolar disorder with mobile health technology

by | Dec 3, 2015 | Bipolar, mHealth

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. [1]

People suffering from bipolar disorder will have periods or episodes of depression – where they feel very low and lethargic mania – where they feel high and overactive. [2]

Unlike simple mood swings, each episode of bipolar disorder can last for several weeks and some people may not experience a “normal” mood very often. [2]

Getting an accurate diagnosis is the first step in bipolar disorder treatment. However, this isn’t always easy. The mood swings of bipolar disorder can be difficult to distinguish from other problems such as major depression, ADHD, and borderline personality disorder. For many people suffering from bipolar disorder, it takes years and numerous doctor visits before the problem is correctly identified and treated. [3]

Indicators of bipolar disorder:

  • Repeated episodes of major depression
  • First episode of major depression was experienced before age 25
  • First-degree relative suffering from bipolar disorder
  • Mood and energy levels are higher than most people’s when not depressed
  • Oversleeping and overeating when depressed
  • Episodes of major depression are shorter than 3 months
  • Lost contact with reality while depressed
  • Suffered from postpartum depression in the past
  • Developed mania or hypomania while taking antidepressants
  • Antidepressants stopped working after several months
  • Tried three or more antidepressants without success [3]

If a person is not treated, episodes of bipolar-related mania can last for between three to six months. Episodes of depression tend to last longer, for between six and twelve months. However, with effective treatment, episodes usually improve within about three months. [2]

Most people with bipolar disorder can be treated using a combination of different treatments that can include:

  • Medication such as mood stabilisers and antidepressants
  • Learning to recognize triggers and early warning signs of an episode of depression or mania
  • Psychotherapy to deal with depression and provide advice on how to improve relationships
  • Lifestyle advice such as doing regular exercise, planning activities you enjoy that give you a sense of achievement, and advice on improving your diet and getting more sleep [2]

Mobile health technology

The Monsenso mHealth platform is based on The MONARCA Research Project, aimed at developing and validating a solution for multi-parametric, long-term monitoring of behavioral and physiological information relevant to bipolar disorder.

The Monsenso solution can help predict and prevent episodes by training patients to recognize their early warning signs, which are symptoms that indicate an oncoming episode [4].

In particular, during the research project, it was discovered that these three parameters are crucial in keeping a bipolar patient stable:

  • Adherence to prescribed medication: Taking all medications on a daily basis, exactly as prescribed.
  • Stable sleep patterns: Sleeping eight hours every night and maintaining a consistent routine of going to bed, waking up.
  • Staying active both physically and socially: Getting out of the house every day, going to work, and engaging in social interaction.

Therefore, the Monsenso solution includes five core features that support a patient’s self-management:

  • Self-assessments – Reminded by an alarm, patients enter subjective data directly into the system through their smartphones. This data includes mood, sleep, level of activity, and medication. Some items can be customized to accommodate a patient’s specific needs, while others are consistent to provide statistical analysis.
  • Activity monitoring – Through a GPS and accelerometer, objective data is collected to monitor a patient’s level of engagement in daily activities. The system can also measure the amount of social activity based on phone calls and text messages.
  • Historical overview of data – On the web portal, patients and clinicians can obtain a two-week snapshot of a patient’s basic data for immediate feedback. The portal also gives them access to a detailed historical overview of the data, enabling them to explore it in depth by going back in time, and focusing on specific variables.
  • Coaching and self-treatment – The MONARCA systems supported psychotherapy in two ways. Firstly, through customizable triggers that notify the patient and clinician when the data potentially indicates a warning sign. Second, since the patients have access to their own Early Warning Signs, it empowers them to learn more about them.
  • Data sharing – To strengthen the relationship between patients and clinicians, important information and treatment decisions are shared.

Resources:

[1] What is bipolar disorder? National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

[2] Bipolar disorder. National Health Service (NHS) UK. http://www.nhs.uk/Conditions/Bipolar-disorder/Pages/Introduction.aspx

[3] Bipolar disorder treatment. HelpGuide.org http://www.helpguide.org/articles/bipolar-disorder/bipolar-disorder-treatment.htm