The statistics are staggering. Statistics Canada data has highlighted the enormous extent and impact that depression and bipolar disorder, the most devastating of the mood disorders, have on victims’ lives. These statistics show that for 2000 and 2001, 12 per cent of the population experienced at least one major depressive episode within the last 12 months. Depression and distress cost Canadians billions of dollars each year in treatment, medication, lost productivity and premature death.
Understanding depression and bipolar mood disorder presents a number of challenges for researchers. A group of researchers, led by Professor Charles Lumsden, Department of Medicine, University of Toronto, with a grant from Bell University Laboratories, is using wireless technology to address the need for accurate and appropriate data collection and to ultimately construct a database of individual mood variation. This database will be used to improve understanding about depression and mania in bipolar disorder.
“The goal is to better understand how normal mood differs from mood in bipolar disorder across the days, months and years of a person’s life,” said Prof. Lumsden. “We hope to understand how we might forecast life-threatening mood swings and how the mathematics of the mind’s life expresses itself through the universal experience called mood.”
The mood variation study is multi-disciplinary with collaboration from Dr. David Kreindler and Dr. Anthony Levitt in the Department of Psychiatry at Sunnybrook & Women’s College Health Sciences Centre and Prof. Nicholas Woolridge at University of Toronto’s Division of Biomedical Communications.
“Given the magnitude of mental health problems in this country this collaborative approach to forecasting analysis of disease progression is very exciting,” said Adele Newton, Business Development Manager, Bell University Laboratories at University of Toronto. “Using technology to create a database of this nature will have lasting value to researchers from Canada and around the world.”
Bell University Laboratories is a collaborative research program funded by Bell Canada. Its model for direct industrial research collaboration provides real-world scenarios to focus innovative, multi-disciplinary research activities.
“We started with a question,” said Prof. Lumsden. “Could there be ideas and methods from psychiatry, cognitive neuroscience, and the modern mathematics of complex systems that will help us understand the small changes in the basic patterns of mood that are common to everyone, and how these patterns change in mood disorders?”
The researchers found intriguing connections between the tempo and modes of changes in individual mood states over days, weeks and months and the mathematical patterns of change being uncovered in apparently very diverse, complex systems like earthquakes, stock markets and major events in world history. These discoveries lead to a set of new computer-based mathematical models of how changes in a person’s mood connect to stressful events they experience and to the mind’s possible strategies for coping with these stresses. The researchers were also able to identify changes in the mathematical model that simulated the way mood variation patterns change in bipolar disorder.
So, with a mathematical model in place, the next step led the researchers to explore existing mood pattern data in bipolar and otherwise normal subjects. Pioneering mood pattern data had previously been obtained using traditional pencil and paper methods. The researchers quickly discovered this data had serious limitations.
The answer was to tap technology to provide the kind of data collection the research team needed to develop their database. The team is collaborative with contributions from experts in psychiatry, mathematical biology, computer animation, and theoretical physics, partnering with industry through the solutions-based approach of Bell University Laboratories. The team was able to use mobile computing to address their need for accurate, digitized, automated data collection and transmission. Using wireless technology to seamlessly link people in their daily lives with a research centre tracking mood dynamics was a first and had never before been tried.
The device used – the pdQ 6035 Smartphone – was manufactured by Kyocera Wireless. The pdQ is a hybrid device which combines a Palm hand-held computer and a cellular telephone.
“A major advantage of using this kind of device is that the Palm Operating System can control the cellular telephone functions of the unit,” said Dr. Lumsden. “So, our mood assessment program can gather the data, then activate the cell phone functions, place the cell phone call to our central data storage unit, transmit the data, and then hang up – all automatically, without further intrusion into the subject’s day.”
Leaps and bounds ahead of traditional pen and pencil methods, the subject is presented with a series of questions through which they describe their current mood state. The questions probe, for example, the person’s current feelings of euphoria, their feelings of fatigue, of depression and so on through a detailed inventory measure that, each time, captures a rich portrait of mood.
The subject responds to each question by using the Palm stylus to place a mark on a scale, displayed as a horizontal straight line on the screen of the wireless unit.
“Using the scale allows the person to tell us where they are between a condition of feeling extremely poorly and feeling extremely well with respect to each mood characteristic,” said Dr. Lumsden. “Our mood software established the numerical position of the mark made on each scale, records this and transmits the information to our project database for study and analysis.”
At the time of each questionnaire, subjects are also given the opportunity to make a text entry in a personal log section of the database. Each person can contribute additional narrative, feelings and experiences they themselves deem relevant. Using the technology for this research, according to Dr. Lumsden, has helped the subjects contribute to the long-term goal of understanding, and ultimately, managing affective illness, such as clinical depression and bipolar disorder. “We are very interested in the possible benefits that this “empowerment” through technology, may in itself have for those who have a mood disorder,” he said. ” ‘From victim to victor’ is the way I like to think about this kind of personal empowerment.”
The new database of mood patterns will have a ‘permanent shelf life’.
“Tracing mood dynamics with unprecedented clinical detail and temporal scope will be a principal resource for new, quantitative assessments of mood change,” said Dr. Lumsden. “Imagine the potential benefits of being able to pick up the “fingerprint” of an impending, debilitating episode of depression or mania in advance. The application of technology in this cross-discipline approach has been invaluable in finding a solution to the kind of data the medical community needs to advance research in bipolar disorders.”