The course of Bipolar Disorder (BD) is variable and difficult to predict. A better understanding of which bipolar patients might develop a recurrence, and when, would help to optimize maintenance treatment and could help predict which patient will respond best to more intensive interventions or monitoring. This could facilitate the implementation of individually tailored/personalized treatment plans (Severus et al 2019). Initial data suggest that ecological momentary assessment (EMA) with continuous real-time monitoring of activity and communication parameters together with wrist-accelerometry could help with this aim (Bauer et al. 2020).
The overarching aim of this project is to study the utility of remote monitoring to improve treatment and outcomes in BD. This will involve three main components. First, we will undertake a systematic review and meta-analysis of existing studies. Second, we will design and implement a qualitative study comparing patients‘ experiences, views, participation and adherence with existing and novel methods of remote assessment in cohorts of patients at KCL and Dresden. Third, we will assess the efficacy of EMA in predicting response/remission/recovery, suicide attempts and new episodes in patients with BD using the same cohorts of patients, potentially validating the potential of EMA for future personalised treatment and monitoring. The patient cohorts used will include 1) in Dresden, the BMBF-funded “BipoLife A3 Smartphone Study” Mühlbauer et al. 2018), a randomized, multicentre, observer-blind, active-control, parallel group trial and 2) in KCL, first episode mania patients within existing “Early Intervention for Psychosis” (EIP) teams who are offered access to smartphone monitoring, and 3) KCL patients attending a virtual Lithium clinic.
- Severus E, Ebner-Priemer U, Beier F, Mühlbauer E, Ritter P, Hill H, Bauer M. Ambulantes Monitoring und digitale Phänotypisierung in Diagnostik und Therapie bipolarer Erkrankungen. [Ambulatory monitoring and digital phenotyping in the diagnostics and treatment of bipolar disorders]. Nervenarzt. 2019;90:1215–20. doi:10.1007/s00115-019-00816-9.
- Bauer M, Glenn T, Geddes J, Gitlin M, Grof P, Kessing LV, et al. Smartphones in mental health: a critical review of background issues, current status and future concerns. Int J Bipolar Disord. 2020;8:2. doi:10.1186/s40345-019-0164-x.
- Mühlbauer E, Bauer M, Ebner-Priemer U, Ritter P, Hill H, Beier F, et al. Effectiveness of smartphone-based ambulatory assessment (SBAA-BD) including a predicting system for upcoming episodes in the long-term treatment of patients with bipolar disorders: study protocol for a randomized controlled single-blind trial. BMC Psychiatry. 2018;18:349. doi:10.1186/s12888-018-1929-y.
Skills/qualities required especially for this project:
- Interest in working directly with patients
- interest in affective disorders research
- capacity to learn and develop statistical prediction modelling expertise with complex datasets; interest in technology based improvements in healthcare
- interest in personalized medicine.