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mHealth Gets Into the Mood

A new project aims to turn the smartphone into a high-tech mood ring. The results could help everyone from soldiers with PTSD to those suffering from bipolar disorder.

By Eric Wicklund

- A new project at Massachusetts General Hospital aims to measure people’s moods by how they use their smartphone.

The two-year project, funded by a $1.8 million grant from the National Institute of Mental Health, will measure a person’s mental state by analyzing his or her voice, call patterns, location and text messages. It’s being developed by Cogito, an MIT-based company that’s working with the U.S. Department of Veterans Affairs to develop mHealth-based behavioral health programs for service members.

Healthcare providers have been using voice recognition and analytics software for the last few years in a number of studies targeting such issues as depression, PTSD, suicidal thoughts and addiction issues.  In one memorable project, researchers even studied social media messages – such as Twitter and Facebook posts – to try to identify people with serious emotional problems.

At MGH, researchers will focus on 1,000 patients with bipolar disorder and depression. The Cogito app will track their location (to see if they’re getting out and engaging in social activities) and frequency of phone calls and texts. Users will also be able to use a “voice diary,” which is then analyzed for mood swings.

The project veers away from typical mHealth studies that gather physiological data, such as pulse, respiration, blood pressure and temperature, and target behaviors. More importantly, the patient is a passive participant, being monitored as he or she goes through a normal day.

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"The current practice of relying on patient-reported mood ratings via periodic surveys poses a number of limitations to the collected data," Dr. Thilo Deckersback, the study’s principal investigator and Associate Director of the Bipolar Clinic and Research Program at MGH, said in a release. "As such, it is our hope that this inclusive and comprehensive approach to tracking and understanding mood disorders will enable our clinical teams to better assess and understand the disease state and ultimately improve real-world outcomes for millions of patients."

The VA is taking an interest in the technology with an eye toward treating service members with PTSD. Healthcare organizations like the American Hospital Association and the World Health Organization see its potential in dealing with a wide range of behavioral health issues, including depression and bipolar disorder.

According to research undertaken in 2012, depression affects roughly 16 percent of adults, or 32 million people, and is significantly higher in people diagnosed with a chronic condition – between 40 percent and 60 percent of those diagnosed with a chronic condition also suffer from depression.

In addition, roughly 85 percent of people diagnosed with a chronic condition aren't correctly diagnosed with depression, and less than one in four individuals with depression receive appropriate treatment.

"While many expect that physical disorders would solely account for disability, major depressive disorder and bipolar disorder are among the top causes globally," Dr. Andrew A. Nierenberg, MD, the Thomas P. Hackett, MD, Endowed Chair in Psychiatry and Director of the Bipolar Research Program at MGH, said in the release. "The goal of this initiative is to understand symptom relapse over the lifecycle of these conditions and offer long-term care and support options for patients. With the yearly combined annual cost of depression and bipolar disorder at greater than $200 billion, we hope to bend the care and cost curve with the help of behavioral analytics synched to this patient population."

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Nierenberg is also the project’s principal investigator for MoodNetwork, a consumer-facing national research network for depression and bipolar disorder that’s providing the participants for the program.

Cogito, which got its start in 2008, is now on the leading edge of the mHealth-fueled behavioral health movement, which seeks to treat patients in their homes and while they’re going through normal, everyday routines, rather than in a clinic or the doctor’s office.

Just last year, researchers at the University of Missouri and its associated MU Health Care, along with the Missouri University of Science and Technology and the Tiger Institute for Health Innovation, developed their own version of a “mood diary.” The app, called MoodTrek, synchs with a Fitbit to gather activity data, then asks the user to pick from one of five emojis that matches his or her mood at various parts of the day. That data is then sent to the user’s healthcare provider.

In another project unveiled last year, researchers at the University of California at San Francisco are using Apple’s ResearchKit platform to collect behavioral health and other data from the city’s gay, lesbian and transgender population, which has a historically higher percentage of depression issues.

As with MoodTrek, the UCSF project depended on patient interaction and involvement.

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“The LGBTQ community has been understudied and underserved in healthcare settings,” Kirsten Bibbins-Domingo, MD, PhD, MAS, professor of epidemiology and biostatistics at the UCSF School of Medicine and director of the UCSF Center for Vulnerable Populations, said in a June 2015 press release. “This timely study helps fill the gap in our understanding of health and disease risk in this population, and importantly involves and engages members of these communities in this health-related research in important and novel ways.”


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