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?

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

Mental health in an unequal world. World Mental Health Day 2021

Mental health in an unequal world. World Mental Health Day 2021

Mental illness, why bother if all goes well? Because the day it hits you or your loved ones, you may be faced with the harsh reality of “Mental Health in an unequal world”. Close to 1 billion people globally are living with a mental disorder. Yet, countries spend on avg. 2% of their national health budgets on mental health leaving a disproportionate gap between demand for mental health services and supply. Each year, October 10th marks the “World Mental Health Day”. This year the theme is “Mental Health in an Unequal World”. 

Originally chosen by the World Federation for Mental Health, the theme Mental Health in an Unequal World” refers to the inequality in access to health services in low- and middle-income countries, where between 75% and 95% of patients with mental disorders have no access to mental health services at all. Despite the universal nature and the magnitude of mental illness, the gap between demand for mental health services and supply remains substantial.

The global pandemic along with the climate crisis and social disarrangement lead the world to a difficult place. To date, the pandemic is impacting people of all ages and backgrounds: Illness, economic impact, job insecurity, and most importantly, physical distancing leading to social isolation and millions of people facing mental health issues.

  • Close to one billion people have a mental disorder and anyone can be affected.
  • Depression is a leading cause of disability worldwide and a major contributor to the global burden of disease. Globally, an estimated 5% of adults suffer from depression.
  • Globally, one in seven 10-19-year-olds suffers from a mental disorder. Half of all such disorders begin by the age of 14, but most go undiagnosed and untreated.
  • People with severe mental disorders like schizophrenia typically die 10-20 years earlier than the general population.
  • One in 100 deaths is by suicide. It is the fourth leading cause of death among young people aged 15-29.
  • The COVID -19 pandemic has had a significant impact on people’s mental health.

The World Federation for Mental Health also addresses the disparity between mental health investment and overall health. On average, countries spend only 2% of their national health budgets on mental health. This has changed little in recent years. Despite the scale of mental illness, the gap between demand for mental health services and supply remains substantial. Unaddressed mental health issues are now a leading global cause of disability and suffering. Yet only 10% receive “adequate” treatment – 75% receive no treatment at all.

The limited global availability of effective mental health treatments and a lack of objective measures of response to treatment, are some of the barriers in advancing patient outcomes. To reduce burden, it is critical to diagnose and monitor mood disorders using widely accessible, less costly, and scalable methods, which can enable a higher degree of specificity in mental health diagnoses and timely detection of clinical deterioration.

Building on the widespread adoption of smartphones, mobile health (mhealth) has gained significant interest as a means for capturing continuous, objectively observable and measurable data of patients’ behaviour and mental state. The data collected on smartphones and sensors represent a new approach aimed at measuring human behaviour and mental health, and thus an opportunity of detecting, assessing, and monitoring psychiatric disorders in a less costly and less burdensome way for the clinician.

The data collected on the smartphone are also referred to as digital biomarkers. These can be collected both passively through inbuilt sensors on the smartphone (physical activity and geolocation, social activity, text messages usage, phone usage, voice and speech pattern or wearables (sleep and activity), and actively via user engagement through self-monitored data/self-assessment data (mood, sleep, stress, medicine adherence).

By collecting this data between physician visits, clinicians can see fluctuations in patients’ mental states, providing a more holistic representation of the patient’s functioning over time. The data hereby offer the opportunity for clinicians to predict relevant outcomes in mood disorders and can thus serve as a tool of triage enabling to provide timely and preventative support to the individuals in critical need.

This approach, also known as digital-enabled psychiatry, has gained considerable interest and been extensively researched over the past decade to offer more people access to high-quality health and social care.

To learn more, visit our Research section here or watch a video on the opportunity of digital-enabled psychiatry from the Week of Health and Innovation conference 2021 in Denmark.

References:

https://wfmh.global/2021-world-mental-health-global-awareness-campaign-world-mental-health-day-theme/

https://www.who.int/publications/i/item/9789240031029

https://www.who.int/campaigns/world-mental-health-day/2021

https://www.who.int/key-messages

[1] https://www.who.int/gho/publications/world_health_statistics/EN_WHS2012_Full.pdf

[2] The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011

[3] OECD – 2015

[4] Economist Intelligence Unit – 2015

Monsenso is ISO 13485 certified

Monsenso is ISO 13485 certified

Quality Policy and Standards

As a technology leader in mobile health (mHealth) solutions for mental health, Monsenso is ISO 13485 certified. ISO 13485 is the gold standard for medical device companies to ensure the quality, safety and efficacy of products in the medical device field. This certification ensures that the product in question, consistently meets customer requirements and regulatory requirements applicable to medical devices and other related services.

Monsenso adheres to the highest security standards. Beyond, being ISO 13485, Monsenso holds the ISO 27001 certifications, a TGA certification and class 1 CE mark.” says Thomas Lethenborg, CEO at Monsenso.

For additional information contact:
Jennifer Highland
Marketing and Communications Manager
Monsenso
+45 81 71 7713
highland@monsenso.com

MONARCA II Research Project: Monitoring and Predicting Illness Activity in Bipolar Disorder

MONARCA II Research Project: Monitoring and Predicting Illness Activity in Bipolar Disorder

The MONARCA II Research Project aims to establish clinical evidence on the use of the Monsenso system. The MONARCA II trial uses a randomised controlled single-blind parallel-group design.

Mental illness

Approximately 25% of all people in Europe and the US experience a mental illness at least once in their lifetime. Currently, the monitoring of mental illness relies on subjective clinical self-reporting rating scales, which were developed more than 50 years ago. The EU-funded MONARCA project established a platform for the daily electronic monitoring of subjective and objective measures of illness activity in bipolar disorder using smartphones. The system supports the treatment of bipolar disorder by collecting (i) self-rated (‘subjective’) data on parameters like mood, stress, and cognitive problems, and (ii) automatically sensor-based (‘objective’) data the patients behaviour in terms of mobility (GPS), physical activity (accelerometer), social activity (telephony and texting), and general phone usage. This data is captured and forwarded to a server, where it can be accessed, visualised, and monitored by the clinical staff and applied for clinical decision support. The MONARCA system is now further developed and supported by Monsenso.

Monsenso’s involvement in the The MONARCA II RESEARCH PROJECT

Patients with bipolar disorder according to ICD-10 who previously have been treated at the Copenhagen Clinic for Affective Disorder, Denmark are included and randomised to either daily use of the Monsenso system including a feedback loop between patients and clinicians (the intervention group) or to the use of a smartphone for normal communicative purposes (the control group) for a 9-month trial period. The trial started in September 2014.

The outcome measures between the intervention group and the control group are:

  • Differences in depressive and manic symptoms; rate of depressive and manic episodes (primary);
  • Automatically generated objective data on measures of illness activity; number of days hospitalised; psychosocial functioning (secondary);
  • Perceived stress; quality of life; self-rated depressive symptoms; self-rated manic symptoms; recovery; empowerment and adherence to medication (tertiary)
  • Ethical permission has been obtained. Positive, neutral and negative findings will be published.

If the system is effective in reducing depressive and/or manic symptoms (and other symptoms of bipolar disorder) and the rate of episodes, there will be basis for extending the use to the treatment of bipolar disorder in general and in larger scale.

To read more download the research paper:

Norwegian hospital aims to reduce hospital readmissions of individuals with bipolar disorder

Norwegian hospital aims to reduce hospital readmissions of individuals with bipolar disorder

Copenhagen, Denmark – 15 November 2016.  Monsenso announced today that the Norwegian hospital, Lovisenberg Diakonale Sykehus, will begin a pilot study with the Monsenso mHealth solution that aims to reduce hospital readmissions of individuals with bipolar disorder. Lovisenberg was signed up as a customer by Computas, Monsenso’s partner in Norway.

The pilot study, which will include individuals with bipolar disorder, aims to reduce hospital readmissions by using the Monsenso mHealth solution to intervene at an early stage.

Thomas Lethenborg, CEO at Monsenso, said that Lovisenberg would conduct a ten-month pilot study to determine if the solution should be widely implemented with other mental illnesses.

“Lovisenberg is  committed to finding innovative solutions that help them provide better care to their patients in a more cost-efficient way. With the implementation of the Monsenso mHealth solution, a patient’s historical, aggregated data will be available more easily,” Mr Lethenborg added.

Kim Petersen, Executive Director at Computas AS, said “We are thrilled to have signed up our first customer with Monsenso.  This type of technology gives new opportunities for the integration of mobile health into the existing mental health services in Norway; and I am confident that once clinicians start experiencing the clinical and financial benefits of implementing the solution, we will sign up more customers in no time!”

 Andreas Joner, Head of Clinic at Lovisenberg, said the trial would allow them to investigate how a remote patient monitoring solution can be used to improve patient care and patient engagement.

“The Monsenso mHealth solution will help us to access and analyse data in a more efficient way. Besides, since most people carry their smartphones all the time, patients can answer their self-assessments and clinical questionnaires wherever they are, without feeling self-conscious,” said Andreas Joner.

The Monsenso mHealth solution for mental illnesses is based on a triple-loop treatment model that connects patients, carers and clinicians and has the potential to reduce hospital readmissions of bipolar patients.

Patients use a smartphone to fill in routine self-assessments that reveal their current state of mind and collect sensor data.  The smartphone app also works as a self-help tool that allows patients to manage their symptoms and the behaviours that trigger those symptoms. Carers are also given a smartphone that allows them to assess the overall well-being of the one they care for, and make notes that are shared with the patient and the clinician.

Clinicians use a web portal that provides historical information on each patient, including routine self-assessments and clinical questionnaires. The portal also allows them to obtain an overview of their patients’ illness progression, symptoms, medication compliance, and medical record keeping.

With more than 1300 employees, Lovisenberg Diakonale Sykehus delivers effective treatment and outpatient care across its multiple sites. The hospital provides specialist care in mental health.

For additional information contact:

Jennifer Highland
Marketing and Communications Manager
Monsenso
+45 81 71 7713
highland@monsenso.com

Tone Hærem
Communications Director
Lovisenberg Diakonale Sykehus
tone.harem@lds.no

Pål Vermund Knudsen
Sales Director
Computas AS
pal.vermund.knudsen@computas.com

About Lovisenberg Diakonale Sykehus
Lovisenberg Diaconal Hospital provides specialised health care services in mental health and internal medicine for 180,000 inhabitants of four City Districts in Oslo (inner city). In addition, mental health services are offered to several other city boroughs. The surgical department performs scheduled operations, and has one of the leading orthopaedic units in Norway. The hospital has 234 beds, more than 2,000 employees, and an extensive out-patient facility. It is a non-profit, privately owned organisation, all services provided are within Public Health. Our mission is to offer diagnostics, treatment, and follow up services of a high quality to all our patients, with equality and respect. Being innovative and finding new solutions is part of this.

About Computas
Computas is an international IT solutions provider based in Norway, delivering solutions all over the world. We deliver services and solutions for work processes and collaboration. Our core competence is systems development, architecture and integration, project management and consulting. We have unique experience, deliver high quality in all projects, and work closely with customers to make the best solutions. The health care system in Norway is changing, and there is a need for smart solutions that can ensure quality and improve the efficiency of health services. The key to solving these challenges is through better use of IT. We are prepared to contribute with our expertise and our solutions aimed at patients and health care workers.  We have delivered everything from work process solutions to apps to help the health sector to work more efficiently and to help patients to have better safety.[/vc_column_text][vc_column_text]You can download this article as PDF in EnglishDanish and Norwegian