Hostname: page-component-54dcc4c588-gwv8j Total loading time: 0 Render date: 2025-09-27T19:31:05.489Z Has data issue: false hasContentIssue false
  • English
  • Français

The effect of smartphone-based monitoring on illness activity in bipolar disorder: the MONARCA II randomized controlled single-blinded trial

Published online by Cambridge University Press:  04 April 2019

Maria Faurholt-Jepsen Open the ORCID record for Maria Faurholt-Jepsen [Opens in a new window] ,
Mads Frost ,
Ellen Margrethe Christensen ,
Jakob E. Bardram ,
Maj Vinberg  and
Lars Vedel Kessing
Maria Faurholt-Jepsen*
Affiliation:
Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
Mads Frost
Affiliation:
IT University of Copenhagen, Rued Langgaards Vej 7, 2300 Copenhagen, Denmark
Ellen Margrethe Christensen
Affiliation:
Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
Jakob E. Bardram
Affiliation:
Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark
Maj Vinberg
Affiliation:
Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
Lars Vedel Kessing
Affiliation:
Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
*
Author for correspondence: Maria Faurholt-Jepsen, E-mail: maria@faurholt-jepsen.dk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Recently, the MONARCA I randomized controlled trial (RCT) was the first to investigate the effect of smartphone-based monitoring in bipolar disorder (BD). Findings suggested that smartphone-based monitoring sustained depressive but reduced manic symptoms. The present RCT investigated the effect of a new smartphone-based system on the severity of depressive and manic symptoms in BD.

Methods

Randomized controlled single-blind parallel-group trial. Patients with BD, previously treated at The Copenhagen Clinic for Affective Disorder, Denmark and currently treated at community psychiatric centres, private psychiatrists or GPs were randomized to the use of a smartphone-based system or to standard treatment for 9 months. Primary outcomes: differences in depressive and manic symptoms between the groups.

Results

A total of 129 patients with BD (ICD-10) were included. Intention-to-treat analyses showed no statistically significant effect of smartphone-based monitoring on depressive (B = 0.61, 95% CI −0.77 to 2.00, p = 0.38) and manic (B = −0.25, 95% CI −1.1 to 0.59, p = 0.56) symptoms. The intervention group reported higher quality of life and lower perceived stress compared with the control group. In sub-analyses, the intervention group had higher risk of depressive episodes, but lower risk of manic episodes compared with the control group.

Conclusions

There was no effect of smartphone-based monitoring. In patient-reported outcomes, patients in the intervention group reported improved quality of life and reduced perceived stress. Patients in the intervention group had higher risk of depressive episodes and reduced risk of manic episodes. Despite the widespread use and excitement of electronic monitoring, few studies have investigated possible effects. Further studies are needed.

Keywords

Bipolar disorderdepressive and manic symptomsillness activityMONARCA IIrandomized controlled trialsmartphoneThe Monsenso system

Information

Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 5 , April 2020 , pp. 838 - 848
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Adli, M, Whybrow, PC, Grof, P, Rasgon, N, Gyulai, L, Baethge, C, Glenn, T and Bauer, M (2005) Use of polypharmacy and self-reported mood in outpatients with bipolar disorder. International Journal of Psychiatry in Clinical Practice 4, 251–256.CrossRefGoogle Scholar
Altman, EG, Hedeker, D, Peterson, JL and Davis, JM (1997) The Altman Self-Rating Mania Scale. Biological Psychiatry 42, 948–955.CrossRefGoogle ScholarPubMed
Angst, J and Sellaro, R (2000) Historical perspectives and natural history of bipolar disorder. Biological Psychiatry 48, 445–457.CrossRefGoogle ScholarPubMed
Anthes, E (2016) Mental health: there's an app for that. Nature 532, 20–23.CrossRefGoogle Scholar
Bardram, J, Frost, M, Szanto, K and Margu, G (2012) The MONARCA self-assessment system: a persuasive personal monitoring system for bipolar patients. In Proceedings of the 2nd ACM SIGHIT International Health Informatics Symposium (IHI ’12). ACM, New York, NY, USA, 21–30. vol 2012, pp 21–30. ACM New York, NY, USA.CrossRefGoogle Scholar
Bardram, JE, Frost, M, Szánto, K, Faurholt-Jepsen, M, Vinberg, M and Kessing, LV (2013) Designing mobile health technology for bipolar disorder: a field trial of the monarca system. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pp2627-2636. New York, NY, USA, 2013.CrossRefGoogle Scholar
Barnes, CW, Hadzi-Pavlovic, D, Wilhelm, K and Mitchell, PB (2015) A web-based preventive intervention program for bipolar disorder: outcome of a 12-months randomized controlled trial. Journal of Affective Disorders 174, 485–492.CrossRefGoogle ScholarPubMed
Bauer, M, Grof, P, Gyulai, L, Rasgon, N, Glenn, T and Whybrow, PC (2004) Using technology to improve longitudinal studies: self-reporting with ChronoRecord in bipolar disorder. Bipolar Disorders 6, 67–74.CrossRefGoogle ScholarPubMed
Bauer, M, Rasgon, N, Grof, P, Gyulai, L, Glenn, T and Whybrow, PC (2005) Does the use of an automated tool for self-reporting mood by patients with bipolar disorder bias the collected data? MedGenMed: Medscape General Medicine 7, 21.Google ScholarPubMed
Bauer, M, Grof, P, Rasgon, N, Glenn, T, Alda, M, Priebe, S, Ricken, R and Whybrow, PC (2006) Mood charting and technology: new approach to monitoring patients with mood disorders. Current Psychiatry Reviews 2, 423–429.CrossRefGoogle Scholar
Bauer, M, Glenn, T, Grof, P, Pfennig, A, Rasgon, NL, Marsh, W, Munoz, RA, Sagduyu, K, Alda, M, Quiroz, D, Sasse, J and Whybrow, PC (2007) Self-reported data from patients with bipolar disorder: frequency of brief depression. Journal of Affective Disorders 101, 227–233.CrossRefGoogle ScholarPubMed
Bauer, M, Wilson, T, Neuhaus, K, Sasse, J, Pfennig, A, Lewitzka, U, Grof, P, Glenn, T, Rasgon, N, Bschor, T and Whybrow, PC (2008) Self-reporting software for bipolar disorder: validation of ChronoRecord by patients with mania. Psychiatry Research 159, 359–366.CrossRefGoogle ScholarPubMed
Bech, P, Rasmussen, NA, Olsen, LR, Noerholm, V and Abildgaard, W (2001) The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. Journal of Affective Disorders 66, 159–164.CrossRefGoogle ScholarPubMed
Ben-Zeev, D, Brian, RM, Jonathan, G, Razzano, L, Pashka, N, Carpenter-Song, E, Drake, RE and Scherer, EA (2018) Mobile health (mHealth) versus clinic-based group intervention for people with serious mental illness: a randomized controlled trial. Psychiatric Services 69, 978–985.CrossRefGoogle ScholarPubMed
Bilderbeck, AC, Atkinson, LZ, McMahon, HC, Voysey, M, Simon, J, Price, J, Rendell, J, Hinds, C, Geddes, JR, Holmes, E, Miklowitz, DJ and Goodwin, GM (2016) Psychoeducation and online mood tracking for patients with bipolar disorder: a randomised controlled trial. Journal of Affective Disorders 205, 245–251.CrossRefGoogle ScholarPubMed
Bopp, JM, Miklowitz, DJ, Goodwin, GM, Stevens, W, Rendell, JM and Geddes, JR (2010) The longitudinal course of bipolar disorder as revealed through weekly text messaging: a feasibility study. Bipolar Disorders 12, 327–334.CrossRefGoogle ScholarPubMed
Boutron, I, Moher, D, Altman, DG, Schulz, KF and Ravaud, P (2008) Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Annals of Internal Medicine 148, 295–309.CrossRefGoogle Scholar
Chan, A-W, Tetzlaff, JM, Altman, DG, Dickersin, K and Moher, D (2013) SPIRIT 2013: new guidance for content of clinical trial protocols. Lancet 381, 91–92.CrossRefGoogle ScholarPubMed
Chinman, M, Young, AS, Schell, T, Hassell, J and Mintz, J (2004) Computer-assisted self-assessment in persons with severe mental illness. The Journal of Clinical Psychiatry 65, 1343–1351.CrossRefGoogle ScholarPubMed
Cohen, S, Kamarck, T and Mermelstein, R (1983) A global measure of perceived stress. Journal of Health and Social Behavior 24, 385–396.CrossRefGoogle ScholarPubMed
Corrigan, PW, Salzer, M, Ralph, RO, Sangster, Y and Keck, L (2004) Examining the factor structure of the recovery assessment scale. Schizophrenia Bulletin 30, 1035–1041.CrossRefGoogle ScholarPubMed
Depp, CA, Mausbach, B, Granholm, E, Cardenas, V, Ben-Zeev, D, Patterson, TL, Lebowitz, BD and Jeste, DV (2010) Mobile interventions for severe mental illness: design and preliminary data from three approaches. The Journal of Nervous and Mental Disease 198, 715–721.CrossRefGoogle ScholarPubMed
Depp, CA, Kim, DH, de Dios, LV, Wang, V and Ceglowski, J (2012) A pilot study of mood ratings captured by mobile phone versus paper-and-pencil mood charts in bipolar disorder. Journal of Dual Diagnosis 8, 326–332.CrossRefGoogle ScholarPubMed
Depp, CA, Ceglowski, J, Wang, VC, Yaghouti, F, Mausbach, BT, Thompson, WK and Granholm, EL (2015) Augmenting psychoeducation with a mobile intervention for bipolar disorder: a randomized controlled trial. Journal of Affective Disorders 174, 23–30.CrossRefGoogle ScholarPubMed
Donker, T, Petrie, K, Proudfoot, J, Clarke, J, Birch, M-R and Christensen, H (2013) Smartphones for smarter delivery of mental health programs: a systematic review. Journal of Medical Internet Research 15, e247.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Brage, S, Vinberg, M, Christensen, EM, Knorr, U, Jensen, HM and Kessing, LV (2012) Differences in psychomotor activity in patients suffering from unipolar and bipolar affective disorder in the remitted or mild/moderate depressive state. Journal of Affective Disorders 141, 457–463.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Vinberg, M, Christensen, EM, Frost, M, Bardram, J and Kessing, LV (2013) Daily electronic self-monitoring of subjective and objective symptoms in bipolar disorder – the MONARCA trial protocol (MONitoring, treAtment and pRediCtion of bipolAr disorder episodes): a randomised controlled single-blind trial. BMJ Open 3, 7.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Frost, M, Vinberg, M, Christensen, EM, Bardram, JE and Kessing, LV (2014 a) Smartphone data as objective measures of bipolar disorder symptoms. Psychiatry Research 217, 1–2.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Vinberg, M, Frost, M, Christensen, EM, Bardram, J and Kessing, LV (2014 b) Daily electronic monitoring of subjective and objective measures of illness activity in bipolar disorder using smartphones – the MONARCA II trial protocol: a randomized controlled single-blind parallel-group trial. BMC Psychiatry 14, 309.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Frost, M, Ritz, C, Christensen, EM, Jacoby, AS, Mikkelsen, RL, Knorr, U, Bardram, JE, Vinberg, M and Kessing, LV (2015 a) Daily electronic self-monitoring in bipolar disorder using smartphones – the MONARCA I trial: a randomized, placebo-controlled, single-blind, parallel group trial. Psychological Medicine 45, 2691–2704.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Vinberg, M, Frost, M, Christensen, EM, Bardram, JE and Kessing, LV (2015 b) Smartphone data as an electronic biomarker of illness activity in bipolar disorder. Bipolar Disorders 17, 715–728.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Busk, J, Frost, M, Vinberg, M, Christensen, EM, Winther, O, Bardram, JE and Kessing, LV (2016 a) Voice analysis as an objective state marker in bipolar disorder. Translational Psychiatry 6, e856.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Munkholm, K, Frost, M, Bardram, JE and Kessing, LV (2016 b) Electronic self-monitoring of mood using IT platforms in adult patients with bipolar disorder: a systematic review of the validity and evidence. BMC Psychiatry 16, 7.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Vinberg, M, Frost, M, Debel, S, Margrethe Christensen, E, Bardram, JE and Kessing, LV (2016 c) Behavioral activities collected through smartphones and the association with illness activity in bipolar disorder. International Journal of Methods in Psychiatric Research 25, 309–323.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Frost, M, Martiny, K, Tuxen, N, Rosenberg, N, Busk, J, Winther, O, Bardram, JE and Kessing, LV (2017) Reducing the rate and duration of Re-ADMISsions among patients with unipolar disorder and bipolar disorder using smartphone-based monitoring and treatment – the RADMIS trials: study protocol for two randomized controlled trials. Trials 18, 277.CrossRefGoogle ScholarPubMed
Faurholt-Jepsen, M, Busk, J, Þórarinsdóttir, H, Frost, M, Bardram, JE, Vinberg, M and Kessing, LV (2018) Objective smartphone data as a potential diagnostic marker of bipolar disorder. Australian & New Zealand Journal of Psychiatry 53, 119–128.CrossRefGoogle ScholarPubMed
FierceWireless (2011) Report: Global smartphone penetration to jump 25% in 2014, led by Asia-Pacific. FierceWireless.Google Scholar
Furukawa, TA, Horikoshi, M, Fujita, H, Tsujino, N, Jinnin, R, Kako, Y, Ogawa, S, Sato, H, Kitagawa, N, Shinagawa, Y, Ikeda, Y, Imai, H, Tajika, A, Ogawa, Y, Akechi, T, Yamada, M, Shimodera, S, Watanabe, N, Inagaki, M and Hasegawa, A (2018) Cognitive and behavioral skills exercises completed by patients with major depression during smartphone cognitive behavioral therapy: secondary analysis of a randomized controlled trial. JMIR Mental Health 5, e4.CrossRefGoogle ScholarPubMed
Hamilton, M (1967) Development of a rating scale for primary depressive illness. The British Journal of Social and Clinical Psychology 6, 278–296.CrossRefGoogle ScholarPubMed
Harrison, PJ, Cipriani, A, Harmer, CJ, Nobre, AC, Saunders, K, Goodwin, GM and Geddes, JR (2016) Innovative approaches to bipolar disorder and its treatment. Annals of the New York Academy of Sciences 1366, 76–89.CrossRefGoogle ScholarPubMed
Hidalgo-Mazzei, D, Mateu, A, Reinares, M, Undurraga, J, Bonnín Cdel, M, Sánchez-Moreno, J, Vieta, E and Colom, F (2015) Self-monitoring and psychoeducation in bipolar patients with a smart-phone application (SIMPLe) project: design, development and studies protocols. BMC Psychiatry 15, 52.CrossRefGoogle ScholarPubMed
Insel, TR (2017) Digital phenotyping: technology for a new science of behavior. JAMA 318, 1215–1216.CrossRefGoogle ScholarPubMed
Judd, LL, Schettler, PJ, Akiskal, HS, Maser, J, Coryell, W, Solomon, D, Endicott, J and Keller, M (2003) Long-term symptomatic status of bipolar I vs. bipolar II disorders. The International Journal of Neuropsychopharmacology 6, 127–137.CrossRefGoogle ScholarPubMed
Kessing, LV, Hansen, MG and Andersen, PK (2004) Course of illness in depressive and bipolar disorders. Naturalistic study, 1994–1999. The British Journal of Psychiatry 185, 372–377.CrossRefGoogle ScholarPubMed
Kessing, LV, Hansen, HV, Hvenegaard, A, Christensen, EM, Dam, H, Gluud, C and Wetterslev, J (2013) Treatment in a specialised out-patient mood disorder clinic v. standard out-patient treatment in the early course of bipolar disorder: randomised clinical trial. The British Journal of Psychiatry 202, 212–219.CrossRefGoogle Scholar
Krzystanek, M, Borkowski, M, Skałacka, K and Krysta, K (2018) A telemedicine platform to improve clinical parameters in paranoid schizophrenia patients: results of a one-year randomized study. Schizophrenia Research 204, 389–396.CrossRefGoogle ScholarPubMed
Kuhs, H and Reschke, D (1992) Psychomotor activity in unipolar and bipolar depressive patients. Psychopathology 25, 109–116.CrossRefGoogle ScholarPubMed
Kupfer, DJ, Weiss, BL, Foster, G, Detre, TP and McPartland, R (1974) Psychomotor activity in affective states. Archives of General Psychiatry 30, 765–768.CrossRefGoogle ScholarPubMed
Lauder, S, Chester, A, Castle, D, Dodd, S, Gliddon, E, Berk, L, Chamberlain, J, Klein, B, Gilbert, M, Austin, DW and Berk, M (2015) A randomized head to head trial of MoodSwings.net.au: an Internet based self-help program for bipolar disorder. Journal of Affective Disorders 171, 13–21.CrossRefGoogle ScholarPubMed
Lieberman, DZ, Kelly, TF, Douglas, L and Goodwin, FK (2010) A randomized comparison of online and paper mood charts for people with bipolar disorder. Journal of Affective Disorders 124, 85–89.CrossRefGoogle ScholarPubMed
Lieberman, DZ, Swayze, S and Goodwin, FK (2011) An automated Internet application to help patients with bipolar disorder track social rhythm stabilization. Psychiatric Services 62, 1267–1269.CrossRefGoogle ScholarPubMed
Moher, D, Hopewell, S, Schulz, KF, Montori, V, Gøtzsche, PC, Devereaux, PJ, Elbourne, D, Egger, M and Altman, DG (2010) CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ (Clinical Research ed.) 340, c869.CrossRefGoogle ScholarPubMed
Mühlbauer, E, Bauer, M, Ebner-Priemer, U, Ritter, P, Hill, H, Beier, F, Kleindienst, N and Severus, E (2018) 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 18, 349.CrossRefGoogle ScholarPubMed
Musiat, P, Goldstone, P and Tarrier, N (2014) Understanding the acceptability of e-mental health – attitudes and expectations towards computerised self-help treatments for mental health problems. BMC Psychiatry 14, 109.CrossRefGoogle ScholarPubMed
Mutschler, J, von Zitzewitz, F, Rossler, W and Grosshans, M (2012) Application of electronic diaries in patients with schizophrenia and bipolar disorders. Psychiatria Danubina 24, 206–210.Google ScholarPubMed
O'Donnell, LA, Ellis, AJ, de Loo, MMV, Stange, JP, Axelson, DA, Kowatch, RA, Schneck, CD and Miklowitz, DJ (2018) Mood instability as a predictor of clinical and functional outcomes in adolescents with bipolar I and bipolar II disorder. Journal of Affective Disorders 236, 199–2206.CrossRefGoogle ScholarPubMed
Patel, R, Lloyd, T, Jackson, R, Ball, M, Shetty, H, Broadbent, M, Geddes, JR, Stewart, R, McGuire, P and Taylor, M (2015) Mood instability is a common feature of mental health disorders and is associated with poor clinical outcomes. BMJ Open 5, e007504.CrossRefGoogle ScholarPubMed
Perry, A, Tarrier, N, Morriss, R, McCarthy, E and Limb, K (1999) Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment. BMJ (Clinical Research ed.) 318, 149–153.CrossRefGoogle ScholarPubMed
Pini, S, de Queiroz, V, Pagnin, D, Pezawas, L, Angst, J, Cassano, GB and Wittchen, H-U (2005) Prevalence and burden of bipolar disorders in European countries. European Neuropsychopharmacology 15, 425–434.CrossRefGoogle ScholarPubMed
Rogers, ES, Chamberlin, J, Ellison, ML and Crean, T (1997) A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatric Services 48, 1042–1047.Google ScholarPubMed
Rosa, AR, Sánchez-Moreno, J, Martínez-Aran, A, Salamero, M, Torrent, C, Reinares, M, Comes, M, Colom, F, Van Riel, W, Ayuso-Mateos, JL, Kapczinski, F and Vieta, E (2007) Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder. Clinical Practice and Epidemiology in Mental Health: CP & EMH 3, 5.CrossRefGoogle Scholar
Saunders, KEA, Cipriani, A, Rendell, J, Attenburrow, M-J, Nelissen, N, Bilderbeck, AC, Vasudevan, SR, Churchill, G, Goodwin, GM, Nobre, AC, Harmer, CJ, Harrison, PJ and Geddes, JR (2016) Oxford lithium Trial (OxLith) of the early affective, cognitive, neural and biochemical effects of lithium carbonate in bipolar disorder: study protocol for a randomised controlled trial. Trials 17.CrossRefGoogle ScholarPubMed
Simon, GE, Ludman, EJ, Bauer, MS, Unützer, J and Operskalski, B (2006) Long-term effectiveness and cost of a systematic care program for bipolar disorder. Archives of General Psychiatry 63, 500–508.CrossRefGoogle ScholarPubMed
Smith, A (2012) Cell internet use 2012. A project of the Pew Research Center. Available at pew.internet.org/Reports/2012/Cell-Internet-Use-2012/Key-Findings.aspxpew.internet.org/Reports/2012/Cell-Internet-Use-2012/Key-Findings.aspx.Google Scholar
Stolz, T, Schulz, A, Krieger, T, Vincent, A, Urech, A, Moser, C, Westermann, S and Berger, T (2018) A mobile app for social anxiety disorder: a three-arm randomized controlled trial comparing mobile and PC-based guided self-help interventions. Journal of Consulting and Clinical Psychology 86, 493–504.CrossRefGoogle ScholarPubMed
Strejilevich, SA, Martino, DJ, Murru, A, Teitelbaum, J, Fassi, G, Marengo, E, Igoa, A and Colom, F (2013) Mood instability and functional recovery in bipolar disorders. Acta Psychiatrica Scandinavica 128, 194–202.CrossRefGoogle ScholarPubMed
Thompson, K, Kulkarni, J and Sergejew, AA (2000) Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophrenia Research 42, 241–247.CrossRefGoogle ScholarPubMed
Todd, NJ, Jones, SH, Hart, A and Lobban, FA (2014) A web-based self-management intervention for bipolar disorder ‘living with bipolar’: a feasibility randomised controlled trial. Journal of Affective Disorders 169, 21–29.CrossRefGoogle ScholarPubMed
Wang, K, Varma, DS and Prosperi, M (2018) A systematic review of the effectiveness of mobile apps for monitoring and management of mental health symptoms or disorders. Journal of Psychiatric Research 107, 73–78.CrossRefGoogle ScholarPubMed
Weinstock, LM and Miller, IW (2008) Functional impairment as a predictor of short-term symptom course in bipolar I disorder. Bipolar Disorders 10, 437–442.CrossRefGoogle ScholarPubMed
WHO (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychological Medicine 28, 551–558.CrossRefGoogle Scholar
WHO (2011) mHealth: New Horizons for Health Through Mobile Technologies. Geneva: WHO. Available at http://www.who.int/goe/publications/goe_mhealth_web.pdf.Google Scholar
Whybrow, PC, Grof, P, Gyulai, L, Rasgon, N, Glenn, T and Bauer, M (2003). The electronic assessment of the longitudinal course of bipolar disorder: the ChronoRecord software. Pharmacopsychiatry 36(suppl. 3), S244–S249.Google ScholarPubMed
Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, Jablenski, A, Regier, D and Sartorius, N (1990) SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry 47, 589–593.CrossRefGoogle ScholarPubMed
World Health Organisation W (2011) ICD-10: International Statistical Classification of Diseases and Related Health Problems, vol 2011. Geneva: World Health Organization.Google Scholar
Young, RC, Biggs, JT, Ziegler, VE and Meyer, DA (1978) A rating scale for mania: reliability, validity and sensitivity. The British Journal of Psychiatry 133, 429–435.CrossRefGoogle ScholarPubMed
Supplementary material: File

Faurholt-Jepsen et al. supplementary material

Faurholt-Jepsen et al. supplementary material 1

Download Faurholt-Jepsen et al. supplementary material(File)
File 20.4 KB