PROJECT NEWSLETTER - ISSUE NO. 1, JULY 2009
P025, DEPARTMENT OF HEALTH SERVICE AND POPULATION RESEARCH,INSTITUTE OF PSYCHIATRY, KING’S COLLEGE LONDON, DE CRESPIGNY PARK ROAD, SE5 8AF, LONDON
GREETINGS... to all of you my beloved and brave participants of the eMonitoring p r o j e c t . I s h o u l d h ave p u t a newsletter together a long time ago, but it is only now that I am getting busy with writing up. The study for now is completed and I ought to say that we did an impressive amount of work together. It has been a long but a challenging and interesting journey in more ways than you can imagine. Most of you had predicted I would have an interesting time ahead dealing with the masses of data we collected. As usual you were right. I am spending days and nights still putting all the databases together.
WHAT WE DID... For starters we did a study together that most people had predicted would not be possible to do. We completed one of the most comprehensive symptom monitoring prog rams possible ever done with people who have a bipolar disorder. Full-stop!!! All in all, out of the 45 people recruited, 37 of you successfully completed most of the study. Yes, you remember correctly, we did 3 months o f d a i ly a n d w e e k ly s y mp t o m monitoring! But read on to learn more...
GEORGE SALAMINIOS started as a junior psychology intern from Brunel university and was instrumental in helping throughout the project. Having achieved a 1st class honours degree, he is now completing an MSc at UCL and is getting ready for his Greek military service.
Looking at the future... So what else lies ahead? Well Preliminary analyses indicate there are 4 interesting studies that at least half of the group that need to be written as a (even though as a group it looks result of our efforts. The first almost symptom free) spends a study will look at the entire considerable amount of time with sub-syndromal depressive symptomatology of the group. It symptoms. This has been shown will give us an idea of what sort before but at least we know we of symptoms are more prevalent are on the same track. In when people are relatively well contrast to previous studies, we we call these “sub-syndromal can look at these symptoms in symptoms”. It will also look at greater detail and can determine how much time people spend far more accurately experiencing these symptoms.
CHEWY CHAN (aka GBOT) was our second junior psychology intern from Brunel university. Despite her worries she also achieved a 1st class honours degree. She is currently looking for jobs in human resources. Chewy (rightly) thinks I am a Greek “Ogre” but at least she loves travelling to Greece.
AGAZI FESSEHAIE was our third and final student intern from Brunel university. Some of you remember his “reminder” emails. He also completed successfully his psychology degree and is currently thinking of going into counselling psychology.
important clinical variables such as symptom peaks, mood switches, and overall symptom variability. These are likely to become future treatment targets, especially if we find that they influence the clinical course of Bipolar disorder.
OUR MECHANICS Dr Kristof Van Laerhoven and his students are working behind the scenes to develop the uber-actiwatch from their evil research lab in Germany. It will not only monitor your activity, but it will also know what you do! They sure aim high! Yes, it is them!
The second study will look at our little baby electronic diary iMonitor (http://myiMonitor.com). This was something that we developed especially for the needs of the current project. It is important for other researchers and clinicians to know how this software was developed and how it performs as a symptom monitoring tool in comparison with other established methods. Preliminary analyses indicate that most of the items included in iMonitor appear to measure what they are meant to measure. I would have liked to see better “correlations” with the clinical measures (our interviews) but iMonitor is just as “bad” as other daily symptom monitoring tools that rely on self-report. More analyses are really needed to determine its “psychometric value” and, most importantly, to see whether what was measured in there can give us an idea in predicting people’s clinical course. This is what we call “predictive validity”, which will be the most significant test of iMonitor.
Andreas Soupianas is the man behind iMonitor. A childhood friend and top programmer from Athens. He did all his work for free in order to help his friend complete his project. We owe him a big manic thank you!
The third study will look at your data I believe to get an idea. These much hated actiwatch and also at activity sensors should be able to your much beloved pedometer. pick up the more severe symptom Approximately half of you used an peaks or changes. The application of actiwatch in order to monitor your these sensors in monitoring bipolar sleep and activity levels. The other disorder is really our first step h a l f u s e d a p e d o m e t e r w h i ch towards moving away from selfc o n t a i n e d a r a t h e r s i m i l a r report methods. Really who wants to accelerometer sensor but costed keep a mood diary all the time? much less. We need to figure out how I don’t. good these gadgets are for monitoring people’s symptoms and The final and fourth study will mood states, more or less like we are investigate the different predictors doing with iMonitor. We have enough of the course. It will be important to Professor Tom Craig acts as a secondary supervisor. He has been instrumental in helping me to clarify my research questions and finalise the outline of my thesis. Professor Craig has an interest in psychosocial predictors of mood disorders.
Both of them have conducted some Professor Dinesh Bhugra has made of the most important studies in the area. the completion of the second part of the study possible. His moral and Hence, the attachment project financial support are helping to see (www.bipolarlab.com/attachment) this study through. He is currently and the childhood experiences acting President of the Royal College interview most of you participated in of Psychiatry, along with being a at a later stage of the project. Professor of Mental Health & Cultural Psychiatry at the Institute. This study is almost over too.
sneak peak at our clinical data
Days monitored Weeks targeted Weeks assessed
2681 766 519
# of Symptom peak s
# of depressive peak s # of manic peaks
3 # of subsyndromal peaks 101 # of episodes
The Final Follow-up? psychological models that make CHRONORECORD STUDY predictions about Bipolar disorder Some of you used ChronoRecord, and its course. These are going to be our desktop pc based electronic a valuable set of preliminary studies diary. Your efforts are already to develop the models further and bearing fruits as we have the first improve the psychological therapies publication out by Dr Bauer that use these models to prevent (German Psychiatrist), Tasha Glenn (ChronoRecord developer) and relapses in Bipolar disorder. We have other important researchers in 3 MSc students who are working on the field (yes, they kindly included these studies as part of their theses. me too). Angeline, Kemi and Rachel will be The study combined data from see and establish whether the writing more about their projects in ChronoRecord centers across the presence and variability of such sub- a forthcoming newsletter. world and looked at the influence syndromal symptoms can predict of climate on mood. who becomes unwell and who stays Dr Emil Kraepelin (pictured left), Contrary to popular beliefs, at well. We have already gathered some the German father of our modern least in this study and our bipolar of our so called “relapse data” and western psychiatry, who also made sample, climate does not seem to that’s why we had the follow ups. But t h e d i s t i n c t i o n b e t w e e n affect your mood! See the attached article-http://is.gd/BFOF ideally we need to have one more schizophrenia and manic depressive illness, was a great advocate of and final follow up. Usually to daily symptom monitoring IN THIS FIRST NEWSLE answer such questions, the longer TTER, methods and the prospective ...I hope you all learned the follow-up time, the better one can something investigation of Bipolar disorder. new about what we determine such things. Ideally, I did an d what we He did it all by himself. He did not are doing with th would have liked you all to have e res ea rch you bother with coaching his patients participated. Your stayed well, and to have had no contribution has really or had to rely on self-report, been invaluable. I wi relapses. But we know that Bipolar ll do my best to but that was a different era and ke ep you informed with disorder is a recurring condition and more papers m a ny o f h i s p a t i e n t s w e r e and newsletters. We r e l a p s e s a r e t h e r e . H o w e v e r, are also looking chronically unwell and were forward to seeing yo whether you had them or not, it will u for one more inpatients. Nowadays and thanks time to conclude all still be important to know. You will the follow-ups for to our modern treatments things my PhD thesis. There all get a final invitation letter/email/ will be lunch, have changed. We can do studies and greek treats as call with the dates of your last follow us ual! As they like the one we did all together, say, “beware of the up. If you can gather your diaries Gr eek s bearing going through our ups and downs gifts”! But we all like and other notes to help us best the m! but at the same time holding still determine what has happened since a n d g o i ng th r ough all the Yours truly, then, you will make our lives a lot assessments. I am sure he would Yanni Malliaris easier. have been proud of us all. More studies to come...in reality See Dr Lieberman’s free web with all the data that we have reincarnation of Dr Kraepelin’s gathered there will be many more Life-Chart: studies to come. Most of the other studies will test different www.moodchart.org vulnerability factors from
+44-207-193-5746 firstname.lastname@example.org m
JON’S MOODSCOPE PROJECT
HELLENIC BIPOLAR ORGANISATION
Also remember to check Jon’s MoodScope project. Jon participated like you in the eMonitoring project and he is public about his experience with Bipolar disorder. Not only did he do an excellent job at it, but was also further inspired to develop his own mood monitoring system. It is best for mild mood disorders and “normal” mood fluctuations.
Last but not least, along with a group of colleagues over the last year and a half, I founded the first MDF-Like organisation for Bipolar patients, their relatives, friends, and professionals in Greece. I founded this in my father’s memory who had the illness and suffered much from it. We hope it grows and one day becomes as big and helpful to Bipolar people as the UK group. If you can read Greek, it’s all here:
DR MIKE HADJULIS, a friendly shrink, was there for me during the study helping in the background to keep my head together as well as to make sure we get all our diagnoses right. He is assisting with the more analytical matters of the study and the clinical value of our results.