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Table 1 Bipolar syndromes matched with sensors (M – manic episode, D- depressive, M/D – applies to both)

From: Mobile psychiatry: towards improving the care for bipolar disorder

Type

Syndrome

Possible sensor

M/D

Altered sleep patterns - insomnia, hypersomnia, self-deprivation of sleep

Possible to monitor with bed sensors as well as light detectors installed in the patient’s home. Effective monitoring of this sleep patterns is of particular importance. Firstly, disturbed sleep can trigger an onset of an episode [25, 26]. Secondly it is an important diagnostic indicator that an episode of either kind is occurring [22].

M

Flight of ideas - increased goal oriented activity, euphoria

Monitoring social activity via, e.g., number of visited places (especially in a patient’s free time), number of calls and text messages and their recipients, Monitoring usage of keyboards and household remote controls should also be included, as buttons are likely to be pressed harder and faster.

M/D

Psychomotor agitation (or retardation)

Body (e.g. wrist) worn accelerometer will detect restless behaviour and increased activity. Motion detection can also be of use.

M

Increased (excessive) social activity

Likely to manifest itself in geospatial and temporal patterns (number of visited places). Patients, in their free time, will visit more unusual places and meet new people. These can be monitored via location (e.g., GPS-based) tracking. Identification of crowded places (e.g. clubs) can be achieved through the patient’s mobile device scanning for other devices [27] or quantifying the noise level of the place where the patient is

M

Talkativeness – a pressure to talk louder

Monitored by microphones designed to extract the pitch and volume of speech (and not the content).

D

Concentration problems – indecisiveness

All activities performed on a computer become only related to work duties (e.g. when using of email and web) and they become slow; monitoring keyboard strokes can show decreased speed of typing. Monitoring of household remote controls may indicate lower use.

D

Lack of interest in social and other activities

Monitoring social activity via, e.g., number of visited places will drop as well as the number of Bluetooth encounters [27].

D

Diminished appetite and loss of weight

Regular weight measurements can be automated as well as basic usage of kitchen appliances being monitored.