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

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