The MONARCA app combines captured data on patterns of movement and social activity with self-reported information on sleep, stress, and emotional status.
New research into digital treatment has led to the development of an app for treating people suffering from depression or bipolar disorder, preventing readmission to hospital. The Copenhagen Center for Health Technology (CACHET) is involved in the development of the app, which can determine whether patients with mental disorders are in a depressive, neutral or manic state. The data will be used to develop a digital treatment system for these patients.
Today we use our smartphones to measure anything from the number of steps we take to our eating habits and whether we are gaining or losing weight. But what if we could also use our phones to determine the development of our state of mind? This is the objective of the MONARCA project. With the help of an app it is possible to determine whether people with affective disorders such as depression and bipolar disorder are in a depressive, manic or neutral state. The app has been developed by Professor of psychiatry at Rigshospitalet Lars Kessing and Professor of IT at DTU Jakob Bardram. The purpose of the app, which is currently undergoing clinical testing, is initially to give patients an overview of the course of their disease, says Jakob Bardram, who is also Director of CACHET.
MONARCA is a model for compiling data and establishing connections. It works almost like an automated psychiatrist, who is able to make a diagnosis based on these data: Is the patient in a depressive, manic or neutral state? This makes it possible to monitor the course of the disease and, if necessary, intervene’, Jakob Bardram says.
Patients Can Monitor the Course of Their Disease
The MONARCA model is available as a system from the company Monsenso and is currently undergoing clinical testing. The test subjects are patients who have been affiliated to Psychiatric Centre Copenhagen and in connection with their treatment have been offered to participate in the project. Each day they are required to state on a given scale what mood they are in, how much sleep they have had, whether they feel stressed and their own assessment of their level of activity. In addition, the app automatically collects information about the patient’s patterns of movement and social activity based on how the patient uses the phone. Based on this data it has been possible to document a strong connection between various behavioural parameters such as mobility and the state of disease, Jakob Bardram says.
’The idea behind the project is to give people with affective disorders a tool that enables them to register and monitor the development of their state of mind. Each day they record the status of a series of different parameters such as stress level and how many hours of sleep they have had, enabling them to compare the development to their state of mind or mood. They can use this to reflect on what affects their disease, and whether there is anything they can do’, he says.
A nurse at Rigshospitalet monitors the patients’ development on various parameters, and if she finds cause for concern she can either contact the patient or initiate ambulant treatment. So far approximately 150 people have used to app over a period of six to nine months.
Phone Therapy
In addition to helping the individual patient monitor the pattern of his or her disease and establish connections, which the patient may be able to change, the MONARCA model is also used in a second project. Patients often need both a psychiatrist and a psychologist. Therefore, CACHET has launched a new project, the aim of which is to produce a kind of digital psychologist. The project is called RADMIS.
‘We want to use the insight into patients’ behaviour provided by the data to produce an app that can help people through cognitive behavioural therapy and patient training. According to WHO, depression is the number one cause of reduced functional capacity in humans, and we do not have enough resources to give patients the help they require. We hope this new project can ease the burden on both patients and therapists’, says Jakob Bardram.
RADMIS is still under development, and the team behind the project are unable to say whether use of the app will lead to fewer or shorter readmissions to hospital. The plan is to test the RADMIS model in a large-scale clinical study to determine, among other things, whether the number of readmissions of patients suffering from depression can be reduced.
CACHET is a collaboration between the University of Copenhagen, the Technical University of Denmark, the Capital Region of Denmark and the City of Copenhagen.
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