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[通过应用程序对双相情感障碍发作进行症状监测和早期预警信号检测——患者和亲属对电子健康需求的看法]

[Symptom Monitoring and Detection of Early Warning Signs in Bipolar Episodes Via App - Views of Patients and Relatives on e-Health Need].

作者信息

Fellendorf Frederike T, Hamm Carlo, Platzer Martina, Lenger Melanie, Dalkner Nina, Bengesser Susanne A, Birner Armin, Queissner Robert, Sattler Matteo, Pilz Rene, Kapfhammer Hans-Peter, Lackner Helmut K, van Poppel Mireille, Reininghaus Eva

机构信息

Psychiatrie und Psychotherapeutische Medizin, Medizinische Universität Graz, Graz, Austria.

Institut für Sportwissenschaften, Karl-Franzens-Universität Graz, Graz, Austria.

出版信息

Fortschr Neurol Psychiatr. 2022 Jun;90(6):268-279. doi: 10.1055/a-1503-4986. Epub 2021 Aug 6.

Abstract

BACKGROUND

The onset and early warning signs of episodes of bipolar disorder are often realized late by those affected. The earlier an incipient episode is treated, the more prognostically favorable the course will be. Symptom monitoring via smartphone application (app) could be an innovative way to recognize and react to early warning signs more swiftly. The aim of this study was to find out whether patients and their relatives consider technical support through an app to be useful and practical in the early warning sign detection and treatment.

METHODS

In the present study, 51 patients with bipolar disorder and 28 relatives were interviewed. We gathered information on whether participants were able to perceive early warning signs in form of behavioral changes sufficiently and in a timely fashion and also whether they would use an app as treatment support tool.

RESULTS

Although 94.1% of the surveyed patients and 78.6% of their relatives felt that they were well informed about the disease, 13.7% and 35.7%, respectively were not fully satisfied with the current treatment options. Early warning signs of every depressive development were noticed by 25.5% of the patients (relatives 10.7%). Every (hypo)manic development was only noticed by 11.8% of the patients (relatives 7.1%); 88.2% of the patients and 85.7% of the relatives noticed the same symptoms recurrently at the beginning of a depression and 70.6% and 67.9%, respectively, at the beginning of a (hypo)manic episode (in particular changes in physical activity, communication behavior and the sleep-wake rhythm). 84.3% of the patients and 89.3% of the relatives stated that they considered technical support that draws attention to mood and activity changes as useful and that they would use such an app for the treatment.

DISCUSSION

The current options for perceiving early warning signs of a depressive or (hypo)manic episode in bipolar disorder are clinically inadequate. Those affected and their relatives desire innovative, technical support. Early detection of symptoms, which often manifest themselves in changes in behavior or activity patterns, is essentiell for managing the course of bipolar disorder. In the future, smartphone apps could be used for clinical treatment and research through objective, continuous and.

摘要

背景

双相情感障碍发作的起始及早期预警信号往往在患者身上被发现得较晚。初期发作越早得到治疗,病程的预后就越有利。通过智能手机应用程序(应用)进行症状监测可能是一种更迅速地识别并应对早期预警信号的创新方式。本研究的目的是了解患者及其亲属是否认为通过应用程序获得的技术支持在早期预警信号检测及治疗中有用且实用。

方法

在本研究中,对51名双相情感障碍患者和28名亲属进行了访谈。我们收集了关于参与者是否能够充分且及时地察觉到以行为变化形式出现的早期预警信号,以及他们是否会将应用程序用作治疗支持工具的信息。

结果

尽管94.1%的受访患者及其78.6%的亲属认为他们对该疾病了解充分,但分别有13.7%和35.7%的患者和亲属对当前的治疗选择不完全满意。25.5%的患者(亲属为10.7%)注意到了每次抑郁发作的早期预警信号。每次(轻)躁狂发作仅被11.8%的患者(亲属为7.1%)注意到;88.2%的患者和85.7%的亲属在抑郁发作开始时反复注意到相同症状,在(轻)躁狂发作开始时分别为70.6%和67.9%(特别是身体活动、沟通行为和睡眠 - 觉醒节律的变化)。84.3%的患者和89.3%的亲属表示,他们认为能提醒注意情绪和活动变化的技术支持是有用的,并且他们会使用这样的应用程序进行治疗。

讨论

目前在临床上,双相情感障碍中感知抑郁或(轻)躁狂发作早期预警信号的方法并不充分。患者及其亲属渴望创新的技术支持。症状的早期检测对于双相情感障碍病程的管理至关重要,这些症状通常表现为行为或活动模式的变化。未来,智能手机应用程序可通过客观、持续的方式用于临床治疗和研究。

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