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25-05-2010 | Mental health | Article

Online chart helps bipolar disorder patients log mood


Free abstract

MedWire News: Patients with bipolar disorder are more likely to regularly fill out an online mood chart than the standard paper-based version, and generally give more detail about their current condition online, study results show.

“By bringing the chart directly to the patient via email, and leveraging the behaviorally reinforcing properties of email checking, an Internet-based chart reduces the effort needed to record moods, and makes this tool available to a broader range of patients,” comment Daniel Lieberman (George Washington University, Washington, DC, USA) and colleagues.

In bipolar disorder mood can fluctuate on a daily basis, and is influenced by multiple interacting variables including social support, environmental stress, medication use, sleep disruption, and internal cyclic processes.

“Optimal treatment management requires data that is both accurate and comprehensive, however, patient recall is often unreliable and subject to inaccuracies and biases,” Lieberman and colleagues note in the Journal of Affective Disorders.

Recently the National Institute of Mental Health developed the daily Life Chart Methodology (LCM) as an alternative to retrospective weekly assessments.

However, adherence has proved to be a problem and only the most motivated patients regularly fill out the chart.

In the study the researchers recruited 48 patients with bipolar disorder, assigning 25 to receive the standard paper LCM chart and 23 to receive a specially adapted online version of the LCM, and followed-up their loggings for 90 days.

The online group filled out approximately twice as many days as the standard group (44.3% vs 20.4%) and also entered complete data for a larger portion of days (55.2% vs 27.7%).

Two thirds of the participants who were assigned to receive paper charts, returned them blank, while nearly 80% of the online participants rated at least 1 day.

Although participants given the online chart were allowed to respond to old emails to rate mood for previous days, 77.0% of the days rated were done on the same day, and 92.3% were recorded within 2 days of the date being rated.

“Rating via email eliminated the need for the rater to incorporate a new routine into his or her life,” Lieberman and colleagues comment.

They add: “As long as the participant was already using email, the mood chart accommodated to his or her routine rather than forcing the participant to accommodate to the program.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Andrew Czyzewski

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