Bipolar disorder in the digital age: new tools for the same illness.

S. Nassir Ghaemi,Paul Summergrad,John Torous

doi:10.1186/s40345-016-0065-1

Abstract

“Nothing is more difficult than to ascertain the length of time that a maniacal patient can exist without sleep.”—Dr. Sutherland (Br J Psychiatry 7(37):1–19, 1861). Dr. Sutherland’s patient was suffering from an acute manic episode, which today is called bipolar illness. 150 years later, we continue to struggle with the same challenges in ascertaining accurate symptoms from patients. In era of new digital tools, the quantified self-movement, and precision medicine, we can ask the question: Can we advance understanding and treatment for bipolar illness beyond asking the same questions as in 1861?

Highlights

“Nothing is more difficult than to ascertain the length of time that a maniacal patient can exist without sleep.”—Dr Sutherland (Br J Psychiatry 7(37):1–19, 1861)
As the term is used in the DSM-5 (Angst 2013), is not the same thing as manic-depressive insanity (MDI), but is rather smaller part of the latter
Kraepelin’s original view of MDI did not involve “classic episodic” bipolar disorder, but rather the reverse: he held that mixed states were the most common mood state, and polarity was irrelevant to diagnosis: what are called “unipolar” depressive episodes were viewed by Kraepelin as part of MDI (Ghaemi and Dalley 2014)

Summary

Introduction

“Nothing is more difficult than to ascertain the length of time that a maniacal patient can exist without sleep.”—Dr Sutherland (Br J Psychiatry 7(37):1–19, 1861). A few decades later, the German psychiatrist Emil Kraepelin began a series of careful observations utilizing notecards to longitudinally assess symptoms and outcomes in insane hospitalized patients. Digital technology Despite this potential, initial studies with digital technologies for monitoring or augmented diagnosis in bipolar illness have not yielded anything near the profound results that Kraepelin achieved with his simple notecards.

Results

Conclusion