Grant Report on SCH: Personalized Depression Treatment Supported by Mobile Sensor Analytics

Jayesh Kamath, Jinbo Bi, Alexander Russell, Bing Wang, Jayesh Kamath, Jinbo Bi, Alexander Russell, Bing Wang

Abstract

We report on the newly started project "SCH: Personalized Depression Treatment Supported by Mobile Sensor Analytics". The current best practice guidelines for treating depression call for close monitoring of patients, and periodically adjusting treatment as needed. This project will advance personalized depression treatment by developing a system, DepWatch, that leverages mobile health technologies and machine learning tools. The objective of DepWatch is to assist clinicians with their decision making process in the management of depression. The project comprises two studies. Phase I collects sensory data and other data, e.g., clinical data, ecological momentary assessments (EMA), tolerability and safety data from 250 adult participants with unstable depression symptomatology initiating depression treatment. The data thus collected will be used to develop and validate assessment and prediction models, which will be incorporated into DepWatch system. In Phase II, three clinicians will use DepWatch to support their clinical decision making process. A total of 128 participants under treatment by the three participating clinicians will be recruited for the study. A number of new machine learning techniques will be developed.

Keywords: data analytics; depression; machine learning; mobile sensing; personalized depression treatment.

Conflict of interest statement

CONFLICTS OF INTEREST The authors declare that they have no conflicts of interest.

Figures

Figure 1.
Figure 1.
DepWatch: high-level approach. The ground truth includes self-reported QIDS (Quick Inventory of Depressive Symptomatology) scores, and Monthly clinician assessment (including review of weekly QIDS scores and participant interview).
Figure 2.
Figure 2.
Two daily questionnaires on mood and anxiety (left) and three weekly questionnaires on safety, tolerability, medication adherence (right).

References

    1. World Health Organization (WHO) 2020. Available from: . Accessed 2020 Apr 26.
    1. Andrade L, Caraveo-Anduaga J, Berglund P, Bijl R, DeGraaf R, Keller M, et al. The epidemiology of major depressive episodes: results from the international consortium of psychiatric epidemiology (ICPE) surveys. Int J Methods Psychiatr Res. 2003;12(1):3–21. doi: 10.1002/mpr.138
    1. Judd LL, Akiskal HS, Zeller PJ, Paulus M, Leon AC, Maser JD, et al. Psychosocial disability during the long-term course of unipolar major depressive disorder. Arch Gen Psychiatry. 2000;57:375–80.
    1. World Health Organization. 2013. Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020. Available from: . Accessed 2020 Apr 26.
    1. Nutt D, Davidson J, Gelenberg A, Higuchi T, Kanba S, Karamustafalioglu O, et al. International consensus statement on major depressive disorder. J Clin Psychiatry. 2010;71(suppl E1):e08.
    1. Kemp A, Gordon E, Rush A, Williams L. Improving the prediction of treatment response in depression: Integration of clinical, cognitive, psychophysiological, neuroimaging, and genetic measures. CNS Spectr 2008;13(12):1066–86.
    1. Simon GE, Perlis RH. Personalized medicine for depression: Can we match patients with treatments? Am J Psychiatry.2010;167(12):1445–55.
    1. Cohen ZD, DeRubeis RJ. Treatment selection in depression. Annu Rev Clin Psychol. 2018;14(15):209–36.
    1. Kennedy SH, Lam RW, McIntyre RS, Tourjman SV, Bhat V, Blier P, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 3. Pharmacological Treatments . Can J Psychiatry. 2016;61(9):540–60.
    1. Morris DW, Toups M, Trivedi MH. Measurement-based care in the treatment of clinical depression. Am J Psychiatry 2015;172(10):1004–13.
    1. Fortney JC, Unu ¨tzer J, Wrenn G, Pyne JM, Smith GR, Schoenbaum M, et al. A tipping point for measurement-based care. Psychiatr Serv 2017;68(2):179–88.
    1. Simon GE, Korff MV, Rutter CM, Peterson DA. Treatment process and outcomes for managed care patients receiving new antidepressant prescriptions from psychiatrists and primary care physicians. Arch Gen Psychiatry. 2001;58(4):395–401.
    1. Rush A, Trivedi M, Wisniewski S, Nierenberg A, Stewart J, Warden D, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. Am J Psychiatry. 2006;163(11):1905–17.
    1. Nierenberg A, McLean N, Alpert J, Worthington J, Rosenbaum J, Fava M. Early nonresponse to fluoxetine as a predictor of poor 8-week outcome. Am J Psychiatry. 1995;152(10):1500–3.
    1. Szegedi A, Mu ¨ller M, Anghelescu I, Klawe C, Kohnen R, Benkert O. Early improvement under mirtazapine and paroxetine predicts later stable response and remission with high sensitivity in patients with major depression. J Clin Psychiatry. 2003;64(4):413–20.
    1. Szegedi A, Jansen W, van Willigenburg A, van der Meulen E, Stassen H, Thase M. Early improvement in the first 2 weeks as a predictor of treatment outcome in patients with major depressive disorder: a meta-analysis including 6562 patients. J Clin Psychiatry. 2009;70(3):344–53.
    1. Henkel V, Seemu ¨ller F, Obermeier M, Adli M, Bauer M, Mundt C, et al. Does early improvement triggered by antidepressants predict response or remission? analysis of data from a naturalistic study on a large sample of inpatients with major depression. J Affect Disord. 2009;115(3):439–49.
    1. Kemp D, Ganocy S, Brecher M, Carlson BX, Edwards S, Eudicone JM, et al. Clinical value of early partial symptomatic improvement in the prediction of response and remission during short-term treatment trials in 3369 subjects with bipolar i or ii depression. J Affect Disord. 2011;130(1–2):171–9.
    1. Muzina DJ, Chambers JS, Camacho TA, Eudicone JM, Forbes RA, Berman RM, et al. Adjunctive aripiprazole for depression: Predictive value of early assessment. Am J Manag Care. 2011;17(12):793–801.
    1. Joel I, Begley A, Mulsant B, Lenze E, Mazumdar S, Dew M, et al. Dynamic prediction of treatment response in late-life depression. Am J Geriatr Psychiatry. 2014;22(2):167–76.
    1. Katzman M, Nierenberg A, Wajsbrot D, Meier E, Prieto R, Pappadopulos E, et al. Speed of improvement in symptoms of depression with desvenlafaxine 50 mg and 100 mg compared with placebo in patients with major depressive disorder. J Clin Psychopharmacol. 2017;37(5):555–61.
    1. Health at a Glance 2011: OECD Indicators Available from: . Accessed 2020 Apr 26.
    1. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Int Med. 2001;16(9):606–13.
    1. Robinson J, Khan N, Fusco L, Malpass A, Lewis G, Dowrick C. Why are there discrepancies between depressed patients’ Global Rating of Change and scores on the Patient Health Questionnaire depression module? A qualitative study of primary care in England. BMJ Open. 2017;7:e014519. doi: 10.1136/bmjopen-2016-014519
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington (VA, USA): American Psychiatric Association; 2013.
    1. Gravenhorst F, Muaremi A, Bardram J, Grünerbl A, Mayora O, Wurzer G, et al. Mobile phones as medical devices in mental disorder treatment: an overview. Pers Ubiquit Comput. 2015;19(2):335–53.
    1. Dogan E, Sander C, Wagner X, Hegerl U, Kohls E. Smartphone-Based Monitoring of Objective and Subjective Data in Affective Disorders: Where Are We and Where Are We Going? Systematic Review. J Med Internet Res. 2017;19(7):e262.
    1. Faurholt-Jepsen M, Bauer M, Kessing LV. Smartphone-based objective monitoring in bipolar disorder: status and considerations. Int J Bipolar Disord. 2018;6(1):6.
    1. Rohani DA, Faurholt-Jepsen M, Kessing LV, Bardram JE. Correlations Between Objective Behavioral Features Collected From Mobile and Wearable Devices and Depressive Mood Symptoms in Patients With Affective Disorders: Systematic Review. JMIR Mhealth Uhealth. 2018;6(8):e165.
    1. Shatte ABR, Hutchinson DM, Teague SJ. Machine learning in mental health: a scoping review of methods and applications. Psychol Med. 2019;49:1426–48.
    1. Faurholt-Jepsen M, Geddes JR, Goodwin GM, Bauer M, Duffy A, Kessing LV, et al. Reporting guidelines on remotely collected electronic mood data in mood disorder (eMOOD)—recommendations. Transl Psychiatry. 2019;9:162.
    1. Razavi R, Gharipour A, Gharipour M. Depression screening using mobile phone usage metadata: a machine learning approach. J Am Med Inform Assoc. 2020;27(4):522–30.
    1. Farhan AA, Lu J, Bi J, Russell A, Wang B, Bamis A . Multi-view Bi-Clustering to Identify Smartphone Sensing Features Indicative of Depression. In: Proceedings of IEEE International Conference on Connected Health: Applications, Systems and Engineering Technologies (CHASE); 2016 Jun 27–29; Washington, DC, USA.
    1. Farhan AA, Yue C, Morillo R, Ware S, Lu J, Bi J, et al. Behavior vs. Introspection: Refining prediction of clinical depression via smartphone sensing data In: Proceedings of Wireless Health; 2016. October 25; Bethesda, USA.
    1. Yue C, Ware S, Morillo R, Lu J, Shang C, Bi J, et al. Fusing Location Data for Depression Prediction In: 2017 IEEE SmartWorld, Ubiquitous Intelligence & Computing, Advanced & Trusted Computed, Scalable Computing & Communications, Cloud & Big Data Computing, Internet of People and Smart City Innovation (SmartWorld/SCALCOM/UIC/ATC/CBDCom/IOP/SCI); 2017 Aug 4–8; San Francisco, USA. New York (US): IEEE; 2018.
    1. Lu J, Shang C, Yue C, Morillo R, Ware S, Kamath J, et al. Joint Modeling of Heterogeneous Sensing Data for Depression Assessment via Multi-task Learning. Proc ACM Interact Mobile Wearable Ubiquitous Technol. 2018;21 10.1145/3191753
    1. Ware S, Yue C, Morillo R, Lu J, Shang C, Bi J, et al. Large-scale Automatic Depression Screening Using Meta-data from WiFi Infrastructure. Proc ACM Interact Mobile Wearable Ubiquitous Technol. 2018;2:195 10.1145/3287073
    1. Ware S, Yue C, Morillo R, Lu J, Shang C, Bi J, et al. Predicting Depressive Symptoms Using Smartphone Data. Smart Health. 2020;15:100093.
    1. Bardram JE, Frost M, Szanto K, Marcu G. The monarca self-assessment system: a persuasive personal monitoring system for bipolar patients. In: Proceedings ACM SIGHIT International Health Informatics Symposium; 2012 Jan 28–30; Miami, USA. New York (USA): IEEE; 2012. p. 21–30.
    1. Faurholt-Jepsen M, Vinberg M, Frost M, Christensen EM, Bardram J, Kessing LV. 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 2014:14:309.
    1. Burns MN, Begale M, Duffecy J, Gergle D, Karr CJ, Giangrande E, et al. Harnessing context sensing to develop a mobile intervention for depression. J Med Internet Res. 2011;13(3):e55.
    1. Wahle F, Kowatsch T, Fleisch E, Rufer M, Weidt S. Mobile sensing and support for people with depression: A pilot trial in the wild. JMIR Mhealth Uhealth. 2016;4(3):e111.
    1. Rush AJ, Trivedi MH, Ibrahim HM, Carmody TJ, Arnow B, Klein DN, et al. The 16-item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry. 2003;54(5):573–83.
    1. Chen K, Xu T, Bi J. Latent sparse modeling of longitudinal multi-dimensional data. In: Proceedings of AAAI Conference on Artificial Intelligence; 2018 Feb 2–7; New Orleans, USA.
    1. Goodfellow I, Pouget-Abadie J, Mirza M, Xu B, Warde-Farley D, Ozair S, et al. Generative adversarial nets. In: Proceedings of the Neural Information Processing Systems Conference; 2014 Dec 8–13; Montréal Canada. San Diego (USA): NIPS Proceedings; 2014. p. 2672–80.

Source: PubMed

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