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  1. Article ; Online: Using digital phenotyping to classify bipolar disorder and unipolar disorder - exploratory findings using machine learning models.

    Faurholt-Jepsen, Maria / Rohani, Darius Adam / Busk, Jonas / Tønning, Morten Lindberg / Frost, Mads / Bardram, Jakob Eyvind / Kessing, Lars Vedel

    European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology

    2024  Volume 81, Page(s) 12–19

    Abstract: The aims were to investigate 1) differences in smartphone-based data on phone usage between bipolar disorder (BD) and unipolar disorder (UD) and 2) by using machine learning models, the sensitivity, specificity, and AUC of the combined smartphone data in ...

    Abstract The aims were to investigate 1) differences in smartphone-based data on phone usage between bipolar disorder (BD) and unipolar disorder (UD) and 2) by using machine learning models, the sensitivity, specificity, and AUC of the combined smartphone data in classifying BD and UD. Daily smartphone-based self-assessments of mood and same-time passively collected smartphone data on smartphone usage was available for six months. A total of 64 patients with BD and 74 patients with UD were included. Patients with BD during euthymic states compared with UD in euthymic states had a lower number of incoming phone calls/ day (B: -0.70, 95%CI: -1.37; -0.70, p=0.040). Patients with BD during depressive states had a lower number of incoming and outgoing phone calls/ day as compared with patients with UD in depressive states. In classification by using machine learning models, 1) overall (regardless of the affective state), patients with BD were classified with an AUC of 0.84, which reduced to 0.48 when using a leave-one-patient-out crossvalidation (LOOCV) approach; similarly 2) during a depressive state, patients with BD were classified with an AUC of 0.86, which reduced to 0.42 with LOOCV; 3) during a euthymic state, patients with BD were classified with an AUC of 0.87, which reduced to 0.46 with LOOCV. While digital phenotyping shows promise in differentiating between patients with BD and UD, it highlights the challenge of generalizing to unseen individuals. It should serve as an complement to comprehensive clinical evaluation by clinicians.
    MeSH term(s) Humans ; Bipolar Disorder/diagnosis ; Bipolar Disorder/psychology ; Emotions ; Machine Learning ; Affect
    Language English
    Publishing date 2024-02-03
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1082947-7
    ISSN 1873-7862 ; 0924-977X
    ISSN (online) 1873-7862
    ISSN 0924-977X
    DOI 10.1016/j.euroneuro.2024.01.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Mood instability and activity/energy instability in patients with bipolar disorder according to day-to-day smartphone-based data - An exploratory post hoc study.

    Faurholt-Jepsen, Maria / Busk, Jonas / Bardram, Jakob Eyvind / Stanislaus, Sharleny / Frost, Mads / Christensen, Ellen Margrethe / Vinberg, Maj / Kessing, Lars Vedel

    Journal of affective disorders

    2023  Volume 334, Page(s) 83–91

    Abstract: Background: Alterations and instability in mood and activity/energy has been associated with impaired functioning and risk of relapse in bipolar disorder. The present study aimed to investigate whether mood instability and activity/energy instability ... ...

    Abstract Background: Alterations and instability in mood and activity/energy has been associated with impaired functioning and risk of relapse in bipolar disorder. The present study aimed to investigate whether mood instability and activity/energy instability are associated, and whether these instability measures are associated with stress, quality of life and functioning in patients with bipolar disorder.
    Methods: Data from two studies were combined for exploratory post hoc analyses. Patients with bipolar disorder provided smartphone-based evaluations of mood and activity/energy levels from day-to-day. In addition, information on functioning, perceived stress and quality of life was collected. A total of 316 patients with bipolar disorder were included.
    Results: A total of 55,968 observations of patient-reported smartphone-based data collected from day-to-day were available. Regardless of the affective state, there was a statistically significant positive association between mood instability and activity/energy instability in all models (all p-values < 0.0001). There was a statistically significant association between mood and activity/energy instability with patient-reported stress and quality of life (e.g., mood instability and stress: B: 0.098, 95 % CI: 0.085; 0.11, p < 0.0001), and between mood instability and functioning (B: 0.045, 95 % CI: 0.0011; 0.0080, p = 0.010).
    Limitations: Findings should be interpreted with caution since the analyses were exploratory and post hoc by nature.
    Conclusion: Mood instability and activity/energy instability is suggested to play important roles in the symptomatology of bipolar disorder. This highlight that monitoring and identifying subsyndromal inter-episodic fluctuations in symptoms is clinically recommended. Future studies investigating the effect of treatment on these measures would be interesting.
    MeSH term(s) Humans ; Bipolar Disorder/psychology ; Smartphone ; Quality of Life/psychology ; Affect ; Emotions
    Language English
    Publishing date 2023-05-04
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 135449-8
    ISSN 1573-2517 ; 0165-0327
    ISSN (online) 1573-2517
    ISSN 0165-0327
    DOI 10.1016/j.jad.2023.04.139
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Irritability in bipolar disorder and unipolar disorder measured daily using smartphone-based data: An exploratory post hoc study.

    Faurholt-Jepsen, Maria / Busk, Jonas / Tønning, Morten Lindberg / Bardram, Jakob Eyvind / Frost, Mads / Vinberg, Maj / Kessing, Lars Vedel

    Acta psychiatrica Scandinavica

    2023  Volume 147, Issue 6, Page(s) 593–602

    Abstract: Objective: To investigate (i) the proportions of time with irritability and (ii) the association between irritability and affective symptoms and functioning, stress, and quality of life in patients with bipolar disorder (BD) and unipolar depressive ... ...

    Abstract Objective: To investigate (i) the proportions of time with irritability and (ii) the association between irritability and affective symptoms and functioning, stress, and quality of life in patients with bipolar disorder (BD) and unipolar depressive disorder (UD).
    Methods: A total of 316 patients with BD and 58 patients with UD provided self-reported once-a-day data on irritability and other affective symptoms using smartphones for a total of 64,129 days with observations. Questionnaires on perceived stress and quality of life and clinical evaluations of functioning were collected multiple times during the study.
    Results: During a depressive state, patients with UD spent a significantly higher proportion of time with presence of irritability (83.10%) as compared with patients with BD (70.27%) (p = 0.045). Irritability was associated with lower mood, activity level and sleep duration and with increased stress and anxiety level, in both patient groups (p-values<0.008). Increased irritability was associated with impaired functioning and increased perceived stress (p-values<0.024). In addition, in patients with UD, increased irritability was associated with decreased quality of life (p = 0.002). The results were not altered when adjusting for psychopharmacological treatments.
    Conclusions: Irritability is an important part of the symptomatology in affective disorders. Clinicians could have focus on symptoms of irritability in both patients with BD and UD during their course of illness. Future studies investigating treatment effects on irritability would be interesting.
    MeSH term(s) Humans ; Bipolar Disorder/drug therapy ; Smartphone ; Quality of Life/psychology ; Depressive Disorder/complications ; Irritable Mood
    Language English
    Publishing date 2023-04-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 103-x
    ISSN 1600-0447 ; 0001-690X
    ISSN (online) 1600-0447
    ISSN 0001-690X
    DOI 10.1111/acps.13558
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Mood and Activity Measured Using Smartphones in Unipolar Depressive Disorder.

    Tønning, Morten Lindbjerg / Faurholt-Jepsen, Maria / Frost, Mads / Bardram, Jakob Eyvind / Kessing, Lars Vedel

    Frontiers in psychiatry

    2021  Volume 12, Page(s) 701360

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2021-07-09
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2021.701360
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Reducing worry and rumination in young adults via a mobile phone app: study protocol of the ECoWeB (Emotional Competence for Well-Being in Young Adults) randomised controlled trial focused on repetitive negative thinking.

    Edge, Daniel / Newbold, Alexandra / Ehring, Thomas / Rosenkranz, Tabea / Frost, Mads / Watkins, Edward R

    BMC psychiatry

    2021  Volume 21, Issue 1, Page(s) 519

    Abstract: Background: Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence skills via a mobile app may be an effective, scalable and acceptable way to do this. A particular risk factor ... ...

    Abstract Background: Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence skills via a mobile app may be an effective, scalable and acceptable way to do this. A particular risk factor for anxiety and depression is elevated worry and rumination (repetitive negative thinking, RNT). An app designed to reduce RNT may prevent future incidence of depression and anxiety.
    Method/design: The Emotional Competence for Well-Being in Young Adults study developed an emotional competence app to be tested via randomised controlled trials in a longitudinal prospective cohort. This off-shoot study adapts the app to focus on targeting RNT (worry, rumination), known risk factors for poor mental health. In this study, 16-24 year olds in the UK, who report elevated worry and rumination on standardised questionnaires are randomised to (i) receive the RNT-targeting app immediately for 6 weeks (ii) a waiting list control who receive the app after 6 weeks. In total, the study will aim to recruit 204 participants, with no current diagnosis of major depression, bipolar disorder or psychosis, across the UK. Assessments take place at baseline (pre-randomisation), 6 and 12 weeks post-randomisation. Primary endpoint and outcome for the study is level of rumination assessed on the Rumination Response Styles Questionnaire at 6 weeks. Worry, depressive symptoms, anxiety symptoms and well-being are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored.
    Discussion: This trial aims to better understand the benefits of tackling RNT via an mobile phone app intervention in young people. This prevention mechanism trial will establish whether targeting worry and rumination directly via an app provides a feasible approach to prevent depression and anxiety, with scope to become a widescale public health strategy for preventing poor mental health and promoting well-being in young people.
    Trial registration: ClinicalTrials.gov , NCT04950257 . Registered 6 July 2021 - Retrospectively registered.
    MeSH term(s) Adolescent ; Anxiety/prevention & control ; Cell Phone ; Depressive Disorder, Major ; Humans ; Mobile Applications ; Pessimism ; Prospective Studies ; Randomized Controlled Trials as Topic ; Young Adult
    Language English
    Publishing date 2021-10-21
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1471-244X
    ISSN (online) 1471-244X
    DOI 10.1186/s12888-021-03536-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Differences in mobility patterns according to machine learning models in patients with bipolar disorder and patients with unipolar disorder.

    Faurholt-Jepsen, Maria / Busk, Jonas / Rohani, Darius Adam / Frost, Mads / Tønning, Morten Lindberg / Bardram, Jakob Eyvind / Kessing, Lars Vedel

    Journal of affective disorders

    2022  Volume 306, Page(s) 246–253

    Abstract: Background: It is essential to differentiate bipolar disorder (BD) from unipolar disorder (UD) as the course of illness and treatment guidelines differ between the two disorders. Measurements of activity and mobility could assist in this discrimination.! ...

    Abstract Background: It is essential to differentiate bipolar disorder (BD) from unipolar disorder (UD) as the course of illness and treatment guidelines differ between the two disorders. Measurements of activity and mobility could assist in this discrimination.
    Aims: 1) To investigate differences in smartphone-based location data between BD and UD, and 2) to investigate the sensitivity, specificity, and AUC of combined location data in classifying BD and UD.
    Methods: Patients with BD and UD completed smartphone-based self-assessments of mood for six months, along with same-time passively collected smartphone data on location reflecting mobility patterns, routine and location entropy (chaos). A total of 65 patients with BD and 75 patients with UD were included.
    Results: A total of 2594 (patients with BD) and 2088 (patients with UD) observations of smartphone-based location data were available. During a depressive state, compared with patients with UD, patients with BD had statistically significantly lower mobility (e.g., total duration of moves per day (e
    Limitations: The relative low symptom severity in the present study may have contributed to the magnitude of the AUC.
    Conclusion: Mobility patterns derived from mobile location data is a promising digital diagnostic marker in discriminating between patients with BD and UD.
    MeSH term(s) Affect ; Bipolar Disorder/diagnosis ; Humans ; Machine Learning ; Self-Assessment ; Smartphone
    Language English
    Publishing date 2022-03-23
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 135449-8
    ISSN 1573-2517 ; 0165-0327
    ISSN (online) 1573-2517
    ISSN 0165-0327
    DOI 10.1016/j.jad.2022.03.054
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  7. Article ; Online: Daily estimates of clinical severity of symptoms in bipolar disorder from smartphone-based self-assessments.

    Busk, Jonas / Faurholt-Jepsen, Maria / Frost, Mads / Bardram, Jakob E / Kessing, Lars Vedel / Winther, Ole

    Translational psychiatry

    2020  Volume 10, Issue 1, Page(s) 194

    Abstract: Currently, the golden standard for assessing the severity of depressive and manic symptoms in patients with bipolar disorder (BD) is clinical evaluations using validated rating scales such as the Hamilton Depression Rating Scale 17-items (HDRS) and the ... ...

    Abstract Currently, the golden standard for assessing the severity of depressive and manic symptoms in patients with bipolar disorder (BD) is clinical evaluations using validated rating scales such as the Hamilton Depression Rating Scale 17-items (HDRS) and the Young Mania Rating Scale (YMRS). Frequent automatic estimation of symptom severity could potentially help support monitoring of illness activity and allow for early treatment intervention between outpatient visits. The present study aimed (1) to assess the feasibility of producing daily estimates of clinical rating scores based on smartphone-based self-assessments of symptoms collected from a group of patients with BD; (2) to demonstrate how these estimates can be utilized to compute individual daily risk of relapse scores. Based on a total of 280 clinical ratings collected from 84 patients with BD along with daily smartphone-based self-assessments, we applied a hierarchical Bayesian modelling approach capable of providing individual estimates while learning characteristics of the patient population. The proposed method was compared to common baseline methods. The model concerning depression severity achieved a mean predicted R
    MeSH term(s) Affect ; Bayes Theorem ; Bipolar Disorder/diagnosis ; Humans ; Psychiatric Status Rating Scales ; Self-Assessment ; Smartphone
    Language English
    Publishing date 2020-06-18
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2609311-X
    ISSN 2158-3188 ; 2158-3188
    ISSN (online) 2158-3188
    ISSN 2158-3188
    DOI 10.1038/s41398-020-00867-6
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  8. Article: Automatically Generated Smartphone Data in Young Patients With Newly Diagnosed Bipolar Disorder and Healthy Controls.

    Melbye, Sigurd / Stanislaus, Sharleny / Vinberg, Maj / Frost, Mads / Bardram, Jakob Eyvind / Kessing, Lars Vedel / Faurholt-Jepsen, Maria

    Frontiers in psychiatry

    2021  Volume 12, Page(s) 559954

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2021-08-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2021.559954
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  9. Article: Service User Experiences of Integrating a Mobile Solution (IMPACHS) Into Clinical Treatment for Psychosis.

    Austin, Stephen F / Frøsig, Anna / Buus, Niels / Lincoln, Tania / von Malachowski, Alissa / Schlier, Bjorn / Frost, Mads / Simonsen, Erik

    Qualitative health research

    2021  Volume 31, Issue 5, Page(s) 942–954

    Abstract: Innovative technological solutions are increasingly being introduced into psychotherapy. Understanding service user perspectives is a key aspect in adapting this technology to treatment. This study investigated service users' personal experience of the ... ...

    Abstract Innovative technological solutions are increasingly being introduced into psychotherapy. Understanding service user perspectives is a key aspect in adapting this technology to treatment. This study investigated service users' personal experience of the utility, challenges, and rewards of using an mHealth solution in cognitive behavioral therapy for psychosis (CBTp). People participating in an early intervention program for psychosis (
    MeSH term(s) Cognitive Behavioral Therapy ; Humans ; Mobile Applications ; Psychotic Disorders/therapy ; Telemedicine
    Language English
    Publishing date 2021-01-23
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1275716-0
    ISSN 1552-7557 ; 1049-7323
    ISSN (online) 1552-7557
    ISSN 1049-7323
    DOI 10.1177/1049732320986556
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: The Validity of Daily Self-Assessed Perceived Stress Measured Using Smartphones in Healthy Individuals: Cohort Study.

    Þórarinsdóttir, Helga / Faurholt-Jepsen, Maria / Ullum, Henrik / Frost, Mads / Bardram, Jakob E / Kessing, Lars Vedel

    JMIR mHealth and uHealth

    2019  Volume 7, Issue 8, Page(s) e13418

    Abstract: Background: Smartphones may offer a new and easy tool to assess stress, but the validity has never been investigated.: Objective: This study aimed to investigate (1) the validity of smartphone-based self-assessed stress compared with Cohen Perceived ... ...

    Abstract Background: Smartphones may offer a new and easy tool to assess stress, but the validity has never been investigated.
    Objective: This study aimed to investigate (1) the validity of smartphone-based self-assessed stress compared with Cohen Perceived Stress Scale (PSS) and (2) whether smartphone-based self-assessed stress correlates with neuroticism (Eysenck Personality Questionnaire-Neuroticism, EPQ-N), psychosocial functioning (Functioning Assessment Short Test, FAST), and prior stressful life events (Kendler Questionnaire for Stressful Life Events, SLE).
    Methods: A cohort of 40 healthy blood donors with no history of personal or first-generation family history of psychiatric illness and who used an Android smartphone were instructed to self-assess their stress level daily (on a scale from 0 to 2; beta values reflect this scale) for 4 months. At baseline, participants were assessed with the FAST rater-blinded and filled out the EPQ, the PSS, and the SLE. The PSS assessment was repeated after 4 months.
    Results: In linear mixed-effect regression and linear regression models, there were statistically significant positive correlations between self-assessed stress and the PSS (beta=.0167; 95% CI 0.0070-0.0026; P=.001), the EPQ-N (beta=.0174; 95% CI 0.0023-0.0325; P=.02), and the FAST (beta=.0329; 95% CI 0.0036-0.0622; P=.03). No correlation was found between smartphone-based self-assessed stress and the SLE.
    Conclusions: Daily smartphone-based self-assessed stress seems to be a valid measure of perceived stress. Our study contains a modest sample of 40 healthy participants and adds knowledge to a new but growing field of research. Smartphone-based self-assessed stress is a promising tool for measuring stress in real time in future studies of stress and stress-related behavior.
    MeSH term(s) Adult ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Perception ; Psychometrics/instrumentation ; Psychometrics/methods ; Psychometrics/standards ; Reproducibility of Results ; Self-Assessment ; Smartphone/instrumentation ; Stress, Psychological/classification ; Surveys and Questionnaires
    Language English
    Publishing date 2019-08-19
    Publishing country Canada
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2719220-9
    ISSN 2291-5222 ; 2291-5222
    ISSN (online) 2291-5222
    ISSN 2291-5222
    DOI 10.2196/13418
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