Data-Driven Learning in High-Resolution Activity Sampling From Patients With Bipolar Depression: Mixed-Methods Study

TY - JOUR

T1 - Data-Driven Learning in High-Resolution Activity Sampling From Patients With Bipolar Depression

T2 - Mixed-Methods Study

AU - Rohani, Darius Adam

AU - Tuxen, Nanna

AU - Quemada Lopategui, Andrea

AU - Kessing, Lars Vedel

AU - Bardram, Jakob Eyvind

PY - 2018/4/1

Y1 - 2018/4/1

N2 - BACKGROUND: Behavioral activation is a pen and paper-based therapy form for treating depression. The patient registers their activity hourly, and together with the therapist, they agree on a plan to change behavior. However, with the limited clinical personnel, and a growing patient population, new methods are needed to advance behavioral activation.OBJECTIVE: The objectives of this paper were to (1) automatically identify behavioral patterns through statistical analysis of the paper-based activity diaries, and (2) determine whether it is feasible to move the behavioral activation therapy format to a digital solution.METHODS: We collected activity diaries from seven patients with bipolar depression, covering in total 2,480 hours of self-reported activities. A pleasure score, on a 1-10 rating scale, was reported for each activity. The activities were digitalized into 6 activity categories, and statistical analyses were conducted.RESULTS: Across all patients, movement-related activities were associated with the highest pleasure score followed by social activities. On an individual level, through a nonparametric Wilcoxon Signed-Rank test, one patient had a statistically significant larger amount of spare time activities when feeling bad (z=-2.045, P=.041). Through a within-subject analysis of covariance, the patients were found to have a better day than the previous, if that previous day followed their diurnal rhythm (ρ=.265, P=.029). Furthermore, a second-order trend indicated that two hours of daily social activity was optimal for the patients (β2=-0.08, t (63)=-1.22, P=.23).CONCLUSIONS: The data-driven statistical approach was able to find patterns within the behavioral traits that could assist the therapist in as well as help design future technologies for behavioral activation.

AB - BACKGROUND: Behavioral activation is a pen and paper-based therapy form for treating depression. The patient registers their activity hourly, and together with the therapist, they agree on a plan to change behavior. However, with the limited clinical personnel, and a growing patient population, new methods are needed to advance behavioral activation.OBJECTIVE: The objectives of this paper were to (1) automatically identify behavioral patterns through statistical analysis of the paper-based activity diaries, and (2) determine whether it is feasible to move the behavioral activation therapy format to a digital solution.METHODS: We collected activity diaries from seven patients with bipolar depression, covering in total 2,480 hours of self-reported activities. A pleasure score, on a 1-10 rating scale, was reported for each activity. The activities were digitalized into 6 activity categories, and statistical analyses were conducted.RESULTS: Across all patients, movement-related activities were associated with the highest pleasure score followed by social activities. On an individual level, through a nonparametric Wilcoxon Signed-Rank test, one patient had a statistically significant larger amount of spare time activities when feeling bad (z=-2.045, P=.041). Through a within-subject analysis of covariance, the patients were found to have a better day than the previous, if that previous day followed their diurnal rhythm (ρ=.265, P=.029). Furthermore, a second-order trend indicated that two hours of daily social activity was optimal for the patients (β2=-0.08, t (63)=-1.22, P=.23).CONCLUSIONS: The data-driven statistical approach was able to find patterns within the behavioral traits that could assist the therapist in as well as help design future technologies for behavioral activation.

U2 - 10.2196/10122

DO - 10.2196/10122

M3 - Journal article

C2 - 29954726

SN - 2368-7959

VL - 5

SP - 1

EP - 12

JO - JMIR Mental Health

JF - JMIR Mental Health

IS - 2

M1 - e10122

ER -