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Pharmacopsychiatry 2003; 36: 244-249
DOI: 10.1055/s-2003-45137
Original Paper
© Georg Thieme Verlag Stuttgart · New York

The Electronic Assessment of the Longitudinal Course of Bipolar Disorder: The ChronoRecord Software

P. C. Whybrow1 , P. Grof2 , L. Gyulai3 , N. Rasgon1, 4 , T. Glenn5 , M. Bauer1, 6
  • 1Neuropsychiatric Institute & the Department of Psychiatry and Biobehavioral Sciences of the David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
  • 2Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, Ottawa, Canada
  • 3Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
  • 4Department of Psychiatry, Stanford School of Medicine, Palo Alto, CA, USA
  • 5ChronoRecord Association, Inc., Fullerton, CA, USA (http://www.chronorecord.org)
  • 6Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Campus Charité-Mitte (CCM), Berlin, Germany
Further Information

Publication History

Publication Date:
15 December 2003 (online)

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Longitudinal studies are the optimal approach when investigating the highly variable course of bipolar disorder, but such studies are expensive, prone to reporting errors and to missing data. Automation of data collection may reduce such errors and improve data quality. The ChronoRecord, validated software that patients can install on a home computer to report mood, medications, sleep, life events, weight and menstrual data, has been designed to achieve such automation. In the trial of the ChronoRecord reported here, 80 of 96 (83 %) patients with bipolar disorder showed high acceptance of this computer-based system for self-report, entering daily recordings for a period of 3-months. This new technology, in addition to providing an accurate longitudinal record for research purposes, also facilitates on-going patient feedback and accurate study monitoring.

Key words

bipolar disorder - longitudinal studies - methodology - self-reporting - ChronoRecord computer software

References

  • 1 Akiskal H S, Hantouche E G, Bourgeois M L, Azorin J M, Sechter D, Allilaire J F, Chatenet-Duchene L, Lancrenon S. Toward a refined phenomenology of mania: combining clinician-assessment and self-report in the French EPIMAN study.  J Affect Disord. 2001;  67 89-96
    CrossrefPubMedGoogle Scholar
  • 2 Akiskal H S, Bourgeois M L, Angst J, Post R, Moller H, Hirschfeld R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders.  J Affect Disord. 2000;  59 (Suppl 1) 5 -30
    CrossrefPubMedGoogle Scholar
  • 3 Albert P S. Longitudinal data analysis (repeated measures) in clinical trials.  Stat Med. 1999;  18 1707-1732
    CrossrefPubMedGoogle Scholar
  • 4 Altman E G, Hedeker D, Peterson J L, Davis J M. The Altman Self-Rating Mania Scale.  Biol Psychiatr. 1997;  42 948-955
    CrossrefPubMedGoogle Scholar
  • 5 American Psychiatric Association. Practice Guideline for the Treatment of Patients with Bipolar Disorder. 2002
    Google Scholar
  • 6 Angst J, Sellaro R. Historical perspectives and natural history of bipolar disorder.  Biol Psychiatr. 2000;  48 445-457
    CrossrefPubMedGoogle Scholar
  • 7 Backhaus J, Junghanns K, Broocks A, Riemann D, Hohagen F. Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia.  J Psychosom Res. 2002;  53 737-740
    CrossrefPubMedGoogle Scholar
  • 8 Bauer M, Grof P, Gyulai L, Rasgon N, Glenn T, Whybrow P C. Using Technology to Improve Longitudinal Studies: Self-Reporting in Bipolar Disorder In press (Bipolar Disorders). 
    Google Scholar
  • 9 Bauer M, Rasgon N, Grof P, Altshuler L, Gyulai L, Glenn T, Whybrow P C. Mood changes related to antidepressants in patients with bipolar disorder. Submitted manuscript. 
    Google Scholar
  • 10 Bauer M S, Vojta C, Kinosian B, Altshuler L, Glick H. The Internal State Scale: replication of its discriminating abilities in a multisite, public sector sample.  Bipolar Disord. 2000;  2 340-346
    CrossrefPubMedGoogle Scholar
  • 11 Bauer M S, Crits-Christoph P, Ball W A, Dewees E, McAllister T, Alahi P, Cacciola J, Whybrow P C. Independent assessment of manic and depressive symptoms by self-rating. Scale characteristics and implications for the study of mania.  Arch Gen Psychiatry. 1991;  48 807-812
    PubMedGoogle Scholar
  • 12 Beck A T. Beck Depression Inventory. Harcourt Brace & Company San Antonio; 1996
    Google Scholar
  • 13 Burt T, IsHak W W. Use of technology in outcome measurement. In: IsHak, WW, Burt T, Sederer LI, (Eds) Outcome measurememt in psychiatry. A critical review. Washington, DC; APA 2002: 383-391
    Google Scholar
  • 14 Carr A C, Ancill R J, Ghosh A, Margo A. Direct assessment of depression by microcomputer. A feasibility study.  Acta Psychiatr Scand. 1981;  64 415-422
    PubMedGoogle Scholar
  • 15 Carroll B J, Feinberg M, Smouse P E, Rawson S G, Greden J F. The Carroll rating scale for depression. I. Development, reliability and validation.  Br J Psychiatry. 1981;  138 194-200
    PubMedGoogle Scholar
  • 16 Cassidy F, Murry E, Forest K, Carroll B J. Signs and symptoms of mania in pure and mixed episodes.  J Affect Disord. 1998;  50 187-201
    CrossrefPubMedGoogle Scholar
  • 17 Cnaan A, Laird N M, Slasor P. Using the general linear mixed model to analyse unbalanced repeated measures and longitudinal data.  Stat Med. 1997;  30 2349-2380
    PubMedGoogle Scholar
  • 18 Cotterchio M, Kreiger N, Darlington G, Steingart A. Comparison of self-reported and physician-reported antidepressant medication use.  Ann Epidemiol. 1999;  9 283-289
    CrossrefPubMedGoogle Scholar
  • 19 Dell'Osso L, Pini S, Cassano G B, Mastrocinque C, Seckinger R A, Saettoni M, Papasogli A, Yale S A, Amador X F. Insight into illness in patients with mania, mixed mania, bipolar depression and major depression with psychotic features.  Bipolar Disord. 2002;  4 315-322
    CrossrefPubMedGoogle Scholar
  • 20 DeMarco T. Controlling Software Projects: Management, Measurements and Estimates. New York; Prentice-Hall 1982
    Google Scholar
  • 21 Denicoff K D, Leverich G S, Nolen W A, Rush A J, McElroy S L, Keck P E, Suppes T, Altshuler L L, Kupka R, Frye M A, Hatef J, Brotman M A, Post R M. Validation of the prospective NIMH-Life-Chart Method (NIMH-LCM-p) for longitudinal assessment of bipolar illness.  Psychol Med. 2000;  30 1391-1397
    CrossrefPubMedGoogle Scholar
  • 22 Edwards L J. Modern statistical techniques for the analysis of longitudinal data in biomedical research.  Pediatr Pulmonol. 2000;  30 330-344
    CrossrefPubMedGoogle Scholar
  • 23 Frye M A, Ketter T A, Leverich G S, Huggins T, Lantz C, Denicoff K D, Post R M. The increasing use of polypharmacotherapy for refractory mood disorders: 22 years of study.  J Clin Psychiatry. 2000;  61 9-15
    PubMedGoogle Scholar
  • 24 Gehrman P, Matt G E, Turingan M, Dinh Q, Ancoli-Israel S. Towards an understanding of self-reports of sleep.  J Sleep Res. 2002;  11 229-236
    CrossrefPubMedGoogle Scholar
  • 25 Gonder-Frederick L A, Julian D M, Cox D J, Clarke W L, Carter W R. Self-measurement of blood glucose. Accuracy of self-reported data and adherence to recommended regimen.  Diabetes Care. 1988;  11 579-585
    PubMedGoogle Scholar
  • 26 Gong H J r, Simmons M S, Clark V A, Tashkin D P. Metered-dose inhaler usage in subjects with asthma: comparison of Nebulizer Chronolog and daily diary recordings.  J Allergy Clin Immunol. 1988;  82 5-10
    PubMedGoogle Scholar
  • 27 Goodman M T, Nomura A M, Wilkens L R, Kolonel L N. Agreement between interview information and physician records on history of menopausal estrogen use.  Am J Epidemiol. 1990;  131 815-825
    PubMedGoogle Scholar
  • 28 Hamilton M. A rating scale for depression.  J Neurol Neurosurg Psychiatry. 1960;  23 56-62
    CrossrefPubMedGoogle Scholar
  • 29 Hirschfeld R M. Bipolar spectrum disorder: improving its recognition and diagnosis.  J Clin Psychiatry. 2001;  62 (Suppl 14) 5-9
    PubMedGoogle Scholar
  • 30 Hyland M E, Kenyon C A, Allen R, Howarth P. Diary keeping in asthma: comparison of written and electronic methods.  BMJ. 1993;  306 487-489
    PubMedGoogle Scholar
  • 31 Jain M G, Rohan T E, Howe G R. Agreement of self-reported use of menopausal hormone replacement therapy with physician reports.  Epidemiology. 1999;  10 260-263
    PubMedGoogle Scholar
  • 32 Judd L L, Akiskal H S, Schettler P J, Coryell W, Maser J, Rice J A, Solomon D A, Keller M B. The comparative clinical phenotype and long term longitudinal episode course of bipolar I and II: a clinical spectrum or distinct disorders.  J Affect Disord. 2003;  73 19-32
    CrossrefPubMedGoogle Scholar
  • 33 Judd L L, Akiskal H S, Schettler P J, Coryell W, Endicott J, Maser J D, Solomon D A, Leon A C, Keller M B. A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder.  Arch Gen Psychiatry. 2003;  60 261-269
    PubMedGoogle Scholar
  • 34 Kobak K A, Greist J H, Jefferson J W, Katzelnick D J, Mundt J C. New technologies to improve clinical trials.  J Clin Psychopharmacol. 2001;  21 255-256
    CrossrefPubMedGoogle Scholar
  • 35 Kobak K A, Greist J H, Jefferson J W, Mundt J C, Katzelnick D J. Computerized assessment of depression and anxiety over the telephone using interactive voice response.  MD Comput. 1999;  16 64-68
    PubMedGoogle Scholar
  • 36 Kraag G R, Gordon D A, Menard H A, Russell A S, Kalish G H. Patient compliance with tenoxicam in family practice.  Clin Ther. 1994;  16 581-593
    PubMedGoogle Scholar
  • 37 Leibenluft E, Ashman S B, Feldman-Naim S, Yonkers K A. Lack of relationship between menstrual cycle phase and mood in a sample of women with rapid cycling bipolar disorder.  Biol Psychiatr. 1999;  46 577-580
    CrossrefPubMedGoogle Scholar

Peter C. Whybrow, MD

Director, Neuropsychiatric Institute & Hospital

760 Westwood Plaza

C7-463

University of California at Los Angeles

Los Angeles

CA, 90024

USA

Phone: 001-310-206 1233

Fax: 001-310-825-3942

Email: pwhybrow@mednet.ucla.edu

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