The longitudinal course of bipolar disorder as revealed through weekly text messaging: a feasibility study

Abstract

Objectives-To examine the feasibility of collecting course of illness data from patients with bipolar I and II disorder, using weekly text-messaged mood ratings, and to examine the time trajectory of symptom ratings based on this method of self-report.Methods-A total of 62 patients with bipolar I (n = 47) or II (n = 15) disorder provided mood data in response to weekly cell phone text messages (n = 54) or e-mail prompts (n = 8). Participants provided weekly ratings using the Altman Self-Rating Mania Scale and the Quick Inventory of Depressive Symptoms-Self Report. Patients with bipolar I and II disorder, and men and women, were compared on percentages of time in depressive or manic mood states over up to two years.Results-Participants provided weekly ratings over an average of 36 (range 1-92) weeks. Compliance with the procedure was 75%. Overall, participants reported depressive symptoms 47.7% of the time compared to 7% of entries reflecting manic symptoms, 8.8% reflecting both depressive and manic symptoms, and 36.5% reflecting euthymic mood. Participants with bipolar I disorder reported more days of depression and were less likely to improve with time than participants with bipolar II disorder. Gender differences observed at the beginning of the study were not observed at follow-up. Conclusions-The results are similar to those of other longitudinal studies of bipolar disorder that use traditional retrospective, clinician-gathered mood data. Text-message based symptom monitoring during routine follow-up may be a reliable alternative to in-person interviews.Keywords illness course; mood chart; psychosocial treatment; short messaging service; text messaging Our limited understanding of the course of mood symptoms in bipolar disorder impedes the development of effective treatments. A greater understanding of weekly fluctuations in the course of mood symptoms in bipolar disorder could improve relapse prevention by allowing providers to intervene shortly after prodromal symptoms first appear. In the majority of longitudinal studies, illness course and treatment efficacy have been measured using observer-rated scales obtained under artificial conditions of incentive. Furthermore, most investigators collect mood data from patients retrospectively. Asking participants to recall

‘SMS’ for mental health – Feasibility and acceptability of using text messages for mental health promotion among young women from urban low income settings in India

“…Personalized text messaging has been used to manage appointments among youth with mental illness, to record mood state in bipolar disorder, in assessment of schizophrenic patients, to prevent relapse in alcohol use disorder, support patients with bulimia nervosa, evaluate mood among patients with depression, communicate medication changes and provide expressions of support (Furber et al, 2011;Spaniel et al, 2008;Granholm et al, 2012;Bopp et al, 2010;Moore et al, 2012;Agyapong et al, 2013;Mä kela et al, 2010). Personalized text messages have also been used for substance cessation (Free et al, 2009;Rodgers et al, 2005).…”

¿Que pueden aportar actualmente las nuevas tecnologías al trastorno bipolar?

“…En el trastorno bipolar, se describe un aumento en la creatividad, que les hace proclives a aceptar nuevos enfoques terapéuticos (Santosa et al, 2007) y a adaptarse rápidamente a estos nuevos sistemas de recogida de información con unos resultados fi ables (Bopp et al, 2010). De hecho, en un estudio se analizaba la aceptabilidad de una intervención de dos semanas de duración llevada a cabo mediante PDAs en un grupo de pacientes con trastorno bipolar.…”

“…En el caso de las intervenciones basadas en el empleo de mensajes de móviles, han sido criticadas por ser demasiado simples, no incluir un feedback bidireccional entre pacientes y médicos y no disponer de datos electrónicos basados en medidas objetivas de la psicopatología afectiva (Bopp et al, 2010).…”

“…SMS: Otras intervenciones han consistido en utilizar mensajes de texto que los pacientes responden semanalmente para monitorizar e identifi car síntomas tempranos de recaída y así poder intervenir precozmente. En un estudio prospectivo que incluyó 62 pacientes con trastorno bipolar tipo I y II, se encontró que los resultados eran similares a los descritos con métodos tradicionales y suponían una alternativa válida de monitorización del humor (Bopp et al, 2010).…”

Bridging the gap between research and clinical practice - a new initiative

“…The system provides a platform that can capture any digital data stream, including physiological data, GPS, actigraphy, etc. 10 Implementation of TC has been supported by OHFT since 2008 and is now offered by the Trust to many patients as a part of standard clinical care. Using TC, an individual can monitor their own physical and mental wellbeing and improve their awareness and understanding of their condition and develop ways to manage it.…”