Today's health care is difficult to imagine without the possibility to objectively measure various physiological parameters related to patients' symptoms (from temperature through blood pressure to complex tomographic procedures). Psychiatric care remains a notable exception that heavily relies on patient interviews and self-assessment. This is due to the fact that mental illnesses manifest themselves mainly in the way patients behave throughout their daily life and, until recently there were no "behavior measurement devices." This is now changing with the progress in wearable activity recognition and sensor enabled smartphones. In this paper, we introduce a system, which, based on smartphone-sensing is able to recognize depressive and manic states and detect state changes of patients suffering from bipolar disorder. Drawing upon a real-life dataset of ten patients, recorded over a time period of 12 weeks (in total over 800 days of data tracing 17 state changes) by four different sensing modalities, we could extract features corresponding to all disease-relevant aspects in behavior. Using these features, we gain recognition accuracies of 76% by fusing all sensor modalities and state change detection precision and recall of over 97%. This paper furthermore outlines the applicability of this system in the physician-patient relations in order to facilitate the life and treatment of bipolar patients.

Abstract-Increase in workload across many organisations and consequent increase in occupational stress is negatively affecting the health of the workforce. Measuring stress and other human psychological dynamics is difficult due to subjective nature of selfreporting and variability between and within individuals. With the advent of smartphones it is now possible to monitor diverse aspects of human behaviour, including objectively measured behaviour related to psychological state and consequently stress. We have used data from the smartphone's built-in accelerometer to detect behaviour that correlates with subjects stress levels. Accelerometer sensor was chosen because it raises fewer privacy concerns (in comparison to location, video or audio recording, for example) and because its low power consumption makes it suitable to be embedded in smaller wearable devices, such as fitness trackers. 30 subjects from two different organizations were provided with smartphones. The study lasted for 8 weeks and was conducted in real working environments, with no constraints whatsoever placed upon smartphone usage. The subjects reported their perceived stress levels three times during their working hours. Using combination of statistical models to classify self reported stress levels, we achieved a maximum overall accuracy of 71% for user-specific models and an accuracy of 60% for the use of similar-users models, relying solely on data from a single accelerometer.

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Mental disorders can have a significant, negative impact on sufferers' lives, as well as on their friends and family, healthcare systems and other parts of society. Approximately 25 % of all people in Europe and the USA experience a mental disorder at least once in their lifetime. Currently, monitoring mental disorders relies on subjective clinical self-reporting rating scales, which were developed more than 50 years ago. In this paper, we discuss how mobile phones can support the treatment of mental disorders by (1) implementing human-computer interfaces to support therapy and (2) collecting relevant data from patients' daily lives to monitor the current state and development of their mental disorders. Concerning the first point, we review various systems that utilize mobile phones for the treatment of mental disorders. We also evaluate how their core design features and dimensions can be applied in other, similar systems. Concerning the second point, we highlight the feasibility of using mobile phones to collect comprehensive data including voice data, motion and location information. Data mining methods are also reviewed and discussed. Based on the presented studies, we summarize advantages and drawbacks of the most promising mobile phone technologies for detecting mood disorders like depression or bipolar disorder. Finally, we discuss practical implementation details, legal issues and business models for the introduction of mobile phones as medical devices.

In this paper we demonstrate how smart phone sensors, specifically inertial sensors and GPS traces, can be used as an objective "measurement device" for aiding psychiatric diagnosis. In a trial with 12 bipolar disorder patients conducted over a total (summed over all patients) of over 1000 days (on average 12 weeks per patient) we have achieved state change detection with a precision/recall of 96%/94% and state recognition accuracy of 80%. The paper describes the data collection, which was conducted as a medical trial in a real life every day environment in a rural area, outlines the recognition methods, and discusses the results.

IntroductionBipolar disorder is an often disabling mental illness with a lifetime prevalence of 1%–2%, a high risk of recurrence of manic and depressive episodes, a lifelong elevated risk of suicide and a substantial heritability. The course of illness is frequently characterised by progressive shortening of interepisode intervals with each recurrence and increasing cognitive dysfunction in a subset of individuals with this condition. Clinically, diagnostic boundaries between bipolar disorder and other psychiatric disorders such as unipolar depression are unclear although pharmacological and psychological treatment strategies differ substantially. Patients with bipolar disorder are often misdiagnosed and the mean delay between onset and diagnosis is 5–10 years. Although the risk of relapse of depression and mania is high it is for most patients impossible to predict and consequently prevent upcoming episodes in an individual tailored way. The identification of objective biomarkers can both inform bipolar disorder diagnosis and provide biological targets for the development of new and personalised treatments. Accurate diagnosis of bipolar disorder in its early stages could help prevent the long-term detrimental effects of the illness.The present Bipolar Illness Onset study aims to identify (1) a composite blood-based biomarker, (2) a composite electronic smartphone-based biomarker and (3) a neurocognitive and neuroimaging-based signature for bipolar disorder.Methods and analysisThe study will include 300 patients with newly diagnosed/first-episode bipolar disorder, 200 of their healthy siblings or offspring and 100 healthy individuals without a family history of affective disorder. All participants will be followed longitudinally with repeated blood samples and other biological tissues, self-monitored and automatically generated smartphone data, neuropsychological tests and a subset of the cohort with neuroimaging during a 5 to 10-year study period.Ethics and disseminationThe study has been approved by the Local Ethical Committee (H-7-2014-007) and the data agency, Capital Region of Copenhagen (RHP-2015-023), and the findings will be widely disseminated at international conferences and meetings including conferences for the International Society for Bipolar Disorders and the World Federation of Societies for Biological Psychiatry and in scientific peer-reviewed papers.Trial registration numberNCT02888262.

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Mobile computing is changing the landscape of clinical monitoring and self-monitoring. One of the major impacts will be in healthcare, where increase in number of sensing modalities is providing more and more information on the state of overall wellbeing, behaviour and health. There are numerous applications of mobile computing that range from wellbeing applications, such as physical fitness, stress or burnout up to applications that target mental disorders including bipolar disorder. Use of information provided by mobile computing devices can track the state of the subjects and also allow for experience sampling in order to gather subjective information. This paper reports on the results obtained from a medical trial with monitoring of bipolar disorder patients and how the episodes of the diseases correlate to the analysis of the data sampled from mobile phone acting as a monitoring device.