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Kanczok J, Jauch-Chara K, Müller FJ. Imagery rescripting and cognitive restructuring for inpatients with moderate and severe depression - a controlled pilot study. BMC Psychiatry 2024; 24:194. [PMID: 38459520 PMCID: PMC10921678 DOI: 10.1186/s12888-024-05637-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/26/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND This controlled pilot study investigates the effect of the combined use of cognitive restructuring (CR) and imagery rescripting (IR) compared to treatment as usual among inpatients with moderate and severe depression. Alongside expert ratings and self-report tools, fitness wristbands were used as an assessment tool. METHODS In addition to the standard inpatient care (SIC) program, 33 inpatients with moderate and severe depression were randomly assigned to an intervention group (two sessions of IR and CR) or an active treatment-as-usual (TAU) control group (two sessions of problem-solving and build-up of positive activity). Depression severity was assessed by the Hamilton Depression Rating Scale-21 (HDRS-21), the Beck Depression Inventory-II (BDI-II), and as a diagnostic adjunct daily step count via the Fitbit Charge 3™. We applied for analyses of HDRS-21 and BDI-II, 2 × 2 repeated-measures analysis of variance (ANOVA), and an asymptotic Wilcoxon test for step count. RESULTS The main effect of time on both treatments was η2 = .402. Based on the data from the HDRS-21, patients in the intervention group achieved significantly greater improvements over time than the TAU group (η2 = .34). The BDI-II data did not demonstrate a significant interaction effect by group (η2 = .067). The daily hourly step count for participants of the intervention group was significantly higher (r = .67) than the step count for the control group. CONCLUSIONS The findings support the utilization of imagery-based interventions for treating depression. They also provide insights into using fitness trackers as psychopathological assessment tools for depressed patients. TRIAL REGISTRATION The trial is registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien) under the registration number: DRKS00030809.
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Affiliation(s)
- Jabin Kanczok
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Christian-Albrechts University, Kiel, Germany.
| | - Kamila Jauch-Chara
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Christian-Albrechts University, Kiel, Germany
| | - Franz-Josef Müller
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Christian-Albrechts University, Kiel, Germany
- Department of Genome Regulation, Max Planck Institute for Molecular Genetics, Berlin, Germany
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Lane E, D'Arcey J, Kidd S, Onyeaka H, Alon N, Joshi D, Torous J. Digital Phenotyping in Adults with Schizophrenia: A Narrative Review. Curr Psychiatry Rep 2023; 25:699-706. [PMID: 37861979 DOI: 10.1007/s11920-023-01467-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE OF REVIEW As care for older adult patients with schizophrenia lacks innovation, technology can help advance the field. Specifically, digital phenotyping, the real-time monitoring of patients' behaviors through smartphone sensors and symptoms through surveys, holds promise as the method can capture the dynamicity and environmental correlates of disease. RECENT FINDINGS Few studies have used digital phenotyping to elucidate adult patients' experiences with schizophrenia. In this narrative review, we summarized the literature using digital phenotyping on adults with schizophrenia. No study focused solely on older adult patients. Studies including all adult patients were heterogeneous in measures used, duration, and outcomes. Despite limited research, digital phenotyping shows potential for monitoring outcomes such as negative, positive, and functional symptoms, as well as predicting relapse. Future research should work to target the symptomology persistent in chronic schizophrenia and ensure all patients have the digital literacy required to benefit from digital interventions and homogenize datasets to allow for more robust conclusions.
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Affiliation(s)
- Erlend Lane
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02115, USA
| | - Jessica D'Arcey
- Slaight Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sean Kidd
- Slaight Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Henry Onyeaka
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Massachusetts General/McLean Hospital, Boston, MA, USA
| | - Noy Alon
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02115, USA
| | - Devayani Joshi
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02115, USA
| | - John Torous
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02115, USA.
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Oudin A, Maatoug R, Bourla A, Ferreri F, Bonnot O, Millet B, Schoeller F, Mouchabac S, Adrien V. Digital Phenotyping: Data-Driven Psychiatry to Redefine Mental Health. J Med Internet Res 2023; 25:e44502. [PMID: 37792430 PMCID: PMC10585447 DOI: 10.2196/44502] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/10/2023] [Accepted: 08/21/2023] [Indexed: 10/05/2023] Open
Abstract
The term "digital phenotype" refers to the digital footprint left by patient-environment interactions. It has potential for both research and clinical applications but challenges our conception of health care by opposing 2 distinct approaches to medicine: one centered on illness with the aim of classifying and curing disease, and the other centered on patients, their personal distress, and their lived experiences. In the context of mental health and psychiatry, the potential benefits of digital phenotyping include creating new avenues for treatment and enabling patients to take control of their own well-being. However, this comes at the cost of sacrificing the fundamental human element of psychotherapy, which is crucial to addressing patients' distress. In this viewpoint paper, we discuss the advances rendered possible by digital phenotyping and highlight the risk that this technology may pose by partially excluding health care professionals from the diagnosis and therapeutic process, thereby foregoing an essential dimension of care. We conclude by setting out concrete recommendations on how to improve current digital phenotyping technology so that it can be harnessed to redefine mental health by empowering patients without alienating them.
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Affiliation(s)
- Antoine Oudin
- Infrastructure for Clinical Research in Neurosciences, Paris Brain Institute, Sorbonne University- Institut national de la santé et de la recherche médicale - Centre national de la recherche scientifique, Paris, France
- Department of Psychiatry, Pitié-Salpêtrière Hospital, Public Hospitals of Sorbonne University, Paris, France
| | - Redwan Maatoug
- Infrastructure for Clinical Research in Neurosciences, Paris Brain Institute, Sorbonne University- Institut national de la santé et de la recherche médicale - Centre national de la recherche scientifique, Paris, France
- Department of Psychiatry, Pitié-Salpêtrière Hospital, Public Hospitals of Sorbonne University, Paris, France
| | - Alexis Bourla
- Infrastructure for Clinical Research in Neurosciences, Paris Brain Institute, Sorbonne University- Institut national de la santé et de la recherche médicale - Centre national de la recherche scientifique, Paris, France
- Department of Psychiatry, Saint-Antoine Hospital, Public Hospitals of Sorbonne University, Paris, France
- Medical Strategy and Innovation Department, Clariane, Paris, France
- NeuroStim Psychiatry Practice, Paris, France
| | - Florian Ferreri
- Infrastructure for Clinical Research in Neurosciences, Paris Brain Institute, Sorbonne University- Institut national de la santé et de la recherche médicale - Centre national de la recherche scientifique, Paris, France
- Department of Psychiatry, Saint-Antoine Hospital, Public Hospitals of Sorbonne University, Paris, France
| | - Olivier Bonnot
- Department of Child and Adolescent Psychiatry, Nantes University Hospital, Nantes, France
- Pays de la Loire Psychology Laboratory, Nantes University, Nantes, France
| | - Bruno Millet
- Infrastructure for Clinical Research in Neurosciences, Paris Brain Institute, Sorbonne University- Institut national de la santé et de la recherche médicale - Centre national de la recherche scientifique, Paris, France
- Department of Psychiatry, Pitié-Salpêtrière Hospital, Public Hospitals of Sorbonne University, Paris, France
| | - Félix Schoeller
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Stéphane Mouchabac
- Infrastructure for Clinical Research in Neurosciences, Paris Brain Institute, Sorbonne University- Institut national de la santé et de la recherche médicale - Centre national de la recherche scientifique, Paris, France
- Department of Psychiatry, Saint-Antoine Hospital, Public Hospitals of Sorbonne University, Paris, France
| | - Vladimir Adrien
- Infrastructure for Clinical Research in Neurosciences, Paris Brain Institute, Sorbonne University- Institut national de la santé et de la recherche médicale - Centre national de la recherche scientifique, Paris, France
- Department of Psychiatry, Saint-Antoine Hospital, Public Hospitals of Sorbonne University, Paris, France
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