DEPARTMENT OF ENGINEERING SCIENCEINSTITUTE OF BIOMEDICAL ENGINEERINGCENTRE FOR DOCTORAL TRAINING IN HEALTHCARE INNOVATION

July 23, 2014

FROM QUESTIONNAIRES TO OBJECTIVE DATA

CONTINUOUS MONITORING OF MANIA AND DEPRESSION SYMPTOMS USING MOBILE PHONE SENSORS

Maxim Osipovsupervised by Prof. Gari Cliffordand Dr. David Clifton

Problem

* WHO. The global burden of disease: 2004 update.

Symptoms

Dimensions ofPsychopathology*

Reality distortionHallucinations, Delusions

PovertyFlat affect, Poverty of speech*,Decreased voluntary motor activity*

DepressionLow mood, Low self-esteem, Hopelessness, Suicidality, Somatic symptoms*

DisorganizationFormal thought disorder, Inappropriate affect, Disorganized or bizarre behavior*

AnxietyFeelings of unease, fear* or dread, Overactivity of the sympathetic nervous system*

* Symptoms can be detected using activity, cardiovascular or electrodermal monitoring

PsychomotorExcitation

Labile affect, Pressure of speech*,Motor agitation*

MoodElation

Elevated mood, Elevated self-esteem, Decreased need for sleep*

* P. F. Liddle, Disordered mind and brain: The neural basis of mental symptoms.

Bipolar disorder

Bipolar Disorder

Lifetime prevalence of ~1.5%

Peak age of first episode onset is in the teens or twenties

20x increase in risk of suicide

“Cyclical” illness, ~10% have 4 or more episodes per year

* DSM-IV

Management

Medication to prevent episodes of mania and depression

Medication to treat the main symptoms

Psychological treatment

Detecting warning signs helps with better treatment

Bipolar disorder - Management

Depression and Mania (QIDS & ASRM)

1. Falling Asleep *2. Sleep During the Night *3. Waking Up Too Early *4. Sleeping Too Much *5. Feeling Sad6,7. Increased / Decreased Appetite8,9. Increased / Decreased Weight10. Concentration / Decision Making11. View of Myself12. Thoughts of Death or Suicide13. General Interest14. Energy Level *15. Feeling Slowed Down *16. Feeling Restless *

1. Happiness2. Self-confidence3. Need for Sleep *4. Talk More *5. Being More Active *

* Can be measured objectively, using mobile or wearable devices.

Automated Monitoring of Symptom Severity (AmoSS) – PI Prof. Gari Clifford

Physical activity

Light exposure

Battery level

Geolocation

Mobile phone data limitations

Integration with self-management platform

Acknowledgments

Hill Foundation Scholarship

RCUK Digital Economy Programme grant number EP/G036861/1 (Oxford Centre for Doctoral Training in Healthcare Innovation)

Wellcome Trust Centre Grant No. 098461/Z/12/Z (Sleep, Circadian Rhythms and Neuroscience Institute)

EPSRC grant EP/K020161/1 (Multiscale markers of circadian rhythm changes for monitoring of mental health)

Acknowledgments - AmoSS Team

Prof. Gari Clifford

Prof. Guy Goodwin

Dr. Athanasios Tsanas

Dr. Amy Bilderbeck

Dr. Kate Saunders

Niclas Palmius

Thank you!