Internet use by older adults with bipolar disorder: international survey results

Information communication technology accessibility and mental health for older adults during the coronavirus disease in South Korea

Introduction

As society ages and the digital economy continues to develop, accessibility to information and communication technology (ICT) has emerged as a critical factor influencing the mental health of older adults. Particularly, in the aftermath of the COVID-19 pandemic, the need for non-face-to-face communication has significantly increased older adults' reliance on ICT for accessibility. This transition from a self-motivated engagement to a more socially passive mode of interaction highlights the importance of creating a digitally inclusive aging society.

Methods

This empirical study used pooled cross-sectional data from the Digital Gap Survey conducted in South Korea in 2018 and 2020. It aimed to analyze the association between ICT accessibility and the mental health of older adults during the COVID-19 pandemic.

Results

A significant positive relationship was found between ICT and mental health among older adults in South Korea. However, this positive association weakened during the COVID-19 period. Furthermore, the analysis revealed heterogeneity among older adults by age, sex, and place of residence, with older females in their 70s living in rural areas experiencing the greatest weakening.

Discussion

These results highlight the need for tailored interventions and support mechanisms for specific demographic groups of older adults. We recommend that the South Korean government implement various policies to facilitate the post-COVID-19 digital landscape. These include initiatives such as ICT-related education programs, development of user-friendly e-government systems, and creation of social media platforms designed to accommodate the needs and preferences of older adults.

Why lithium should be used in patients with bipolar disorder? A scoping review and an expert opinion paper

INTRODUCTION

Lithium treatment is considered the gold standard for the long-term management of bipolar disorder and recurrent unipolar depression. It is also extremely effective in other psychiatric conditions characterized by impulsivity and aggression, and for the prevention of suicidal behaviours.

AREAS COVERED

This paper provides a scoping review and an expert commentary regarding the use of lithium in adult patients. Available information about efficacy, tolerability, dosing, and switching is analyzed, and the strategies that may be most useful in real-world clinical settings are highlighted.

EXPERT OPINION

Lithium is effective on different domains of bipolar disorder, including the long-term prevention of recurrences of affective episodes, management of acute mania as well as in the prophylaxis of all affective episodes. Lithium has been defined a 'forgotten drug,' since its use in routine clinical practice has been declined over the last 20 or 30 years. Reasons for this trend include lack of adequate training on the management of lithium side effects. Considering its efficacy, use of lithium in ordinary clinical practice should be promoted. Several strategies, such as using slow-release formulations, can be easily implemented in order to minimize lithium side effects and improve its tolerability profile.

An examination of the quality of late-life depression websites on the Internet (Preprint)

Background

The internet can increase the accessibility of mental health information and improve the mental health literacy of older adults. The quality of mental health information on the internet can be inaccurate or biased, leading to misinformation.

Objective

This study aims to evaluate the quality, usability, and readability of websites providing information concerning depression in later life.

Methods

Websites were identified through a Google search and evaluated by assessing quality (DISCERN), usability (Patient Education Materials Assessment Tool), and readability (Simple Measure of Gobbledygook).

Results

The overall quality of late-life depression websites (N=19) was adequate, and the usability and readability were poor. No significant relationship was found between the quality and readability of the websites.

Conclusions

The websites can be improved by enhancing information quality, usability, and readability related to late-life depression. The use of high-quality websites may improve mental health literacy and shared treatment decision-making for older adults.

An Explainable Intelligence Driven Query Prioritization Using Balanced Decision Tree Approach for Multi-Level Psychological Disorders Assessment

Human emotions affect psychological health to a great level. Positive emotions relate to health improvement; whereas negative emotions may aggravate psychological disorders such as anxiety, stress, and depression. Although there exist several computational methods to predict psychological disorders, most of them provide a black-box view of uncertainty. This research involves developing a novel predictive model for multi class psychological risk recognition with an accurate explainable interface. Standard questionnaires are utilized as data set and a new approach called a Q-Prioritization is employed to drop insignificant questions from the data set. Moreover, a novel balanced decision tree method based on repetitive oversampling is applied for the training and testing of the model. Predictive nature along with its contributing factors are interpreted with three techniques such as permuted feature importance, contrastive explanation, and counterfactual method, which together form a reasoning engine. The prediction outcome generated an impressive performance with an aggregated accuracy of 98.25%. The mean precision, recall, and F-score metric recorded were 0.98, 0.977, and 0.979, respectively. Also, it was noted that without applying Q-Prioritization, the accuracy significantly drops to 90.25%. The error rate observed with our model was only 0.026. The proposed multi-level psychological disorder predictive model can successfully serve as an assistive deployment for medical experts in the effective treatment of mental health.

Internet use and need for digital health technology among the elderly: a cross-sectional survey in China

Background

China is becoming an aging society at the fastest pace in history, and there are a large number of empty nesters in the country. With economic and social development, internal support systems among families are gradually weakening. Supporting the elderly is thus emerging as a significant issue, and promoting digital health technologies is an effective way to help address it. Encouraging the application of Internet to elderly care and Internet use among the elderly are important means of promoting digital health technologies. This paper examines the current state of the use of the Internet by the elderly and factors influencing it (including physical, psychological, and social) as well as demand among the elderly for smart services.

Methods

A total of 669 subjects over the age of 60 years were randomly selected from 13 cities in Heilongjiang province and surveyed using questionnaires from May 1 to July 31, 2018. The questionnaires were collected for descriptive statistics, the chi-square test, and the analysis of influential factors.

Results

Of the people surveyed, 38.6% used the Internet. Their favorite online activity was online dating (74.2%), and the health information they obtained through the Internet was mainly related to diet (63.1%) and exercise (47.1%). The subjects demanded smart bracelets (MD = 2.80) and emergency callers (MD = 2.77). Gender, age, education, monthly income, quality of life, number of friends, and social participation were found to have an impact on Internet use.

Conclusions

More measures are needed to reduce barriers to the use of the Internet and promote digital health technologies. The society, equipment manufacturers, and family members of the elderly should work together to enable them to reap the benefits of online technologies.

Smartphones in mental health: a critical review of background issues, current status and future concerns

There has been increasing interest in the use of smartphone applications (apps) and other consumer technology in mental health care for a number of years. However, the vision of data from apps seamlessly returned to, and integrated in, the electronic medical record (EMR) to assist both psychiatrists and patients has not been widely achieved, due in part to complex issues involved in the use of smartphone and other consumer technology in psychiatry. These issues include consumer technology usage, clinical utility, commercialization, and evolving consumer technology. Technological, legal and commercial issues, as well as medical issues, will determine the role of consumer technology in psychiatry. Recommendations for a more productive direction for the use of consumer technology in psychiatry are provided.

Preferences of Information Dissemination on Treatment for Bipolar Disorder: Patient-Centered Focus Group Study

BACKGROUND

Patient education has taken center stage in successfully shared decision making between patients and health care providers. However, little is known about how patients with bipolar disorder typically obtain information on their illness and the treatment options available to them.

OBJECTIVE

This study aimed to obtain the perspectives of patients with bipolar disorder and their family members on the preferred and most effectively used information channels on bipolar disorder and the available treatment options.

METHODS

We conducted nine focus groups in Montana, New Mexico, and California, in which we surveyed 84 individuals including patients with bipolar disorder and family members of patients with bipolar disorder. The participants were recruited using National Alliance on Mental Illness mailing lists and websites. Written verbatim responses to semistructured questionnaires were analyzed using summative content analysis based on grounded theory. Two annotators coded and analyzed the data on the sentence or phrase level to create themes. Relationships between demographics and information channel were also examined using the Chi-square and Fisher exact tests.

RESULTS

The focus group participants mentioned a broad range of information channels that were successfully used in the past and could be recommended for future information dissemination. The majority of participants used providers (74%) and internet-based resources (75%) as their main information sources. There was no association between internet use and basic demographics such as age or geographical region of the focus groups. Patients considered time constraints and the fast pace in which an overwhelming amount of information is often presented by the provider as major barriers to successful provider-patient interactions. If Web-based channels were used, the participants perceived information obtained through Web-based channels as more helpful than information received in the provider's office (P<.05).

CONCLUSIONS

Web-based resources are increasingly used by patients with bipolar disorder and their family members to educate themselves about the disease and its treatment. Although provider-patient interactions are frequently perceived to be burdened with time constraints, Web-based information sources are considered reliable and helpful. Future research should explore how high-quality websites could be used to empower patients and improve provider-patient interactions with the goal of enhancing shared decision making between patients and providers.

Improving Functioning, Quality of Life, and Well-being in Patients With Bipolar Disorder

People with bipolar disorder frequently experience persistent residual symptoms, problems in psychosocial functioning, cognitive impairment, and poor quality of life. In the last decade, the treatment target in clinical and research settings has focused not only on clinical remission, but also on functional recovery and, more lately, in personal recovery, taking into account patients' well-being and quality of life. Hence, the trend in psychiatry and psychology is to treat bipolar disorder in an integrative and holistic manner. This literature review offers an overview regarding psychosocial functioning in bipolar disorder. First, a brief summary is provided regarding the definition of psychosocial functioning and the tools to measure it. Then, the most reported variables influencing the functional outcome in patients with bipolar disorder are listed. Thereafter, we include a section discussing therapies with proven efficacy at enhancing functional outcomes. Other possible therapies that could be useful to prevent functional decline and improve functioning are presented in another section. Finally, in the last part of this review, different interventions directed to improve patients' well-being, quality of life, and personal recovery are briefly described.