Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality

August 22, 2015 by  
Filed under Research

Mobile apps abound, but are they any good?

This is one of the few studies I’ve seen to actually look at the quality of apps for a specific diagnosis. Here’s the abstract of the study:

With continued increases in smartphone ownership, researchers and clinicians are investigating the use of this technology to enhance the management of chronic illnesses such as bipolar disorder (BD). Smartphones can be used to deliver interventions and psychoeducation, supplement treatment, and enhance therapeutic reach in BD, as apps are cost-effective, accessible, anonymous, and convenient. While the evidence-based development of BD apps is in its infancy, there has been an explosion of publicly available apps. However, the opportunity for mHealth to assist in the self-management of BD is only feasible if apps are of appropriate quality.

Our aim was to identify the types of apps currently available for BD in the Google Play and iOS stores and to assess their features and the quality of their content.

A systematic review framework was applied to the search, screening, and assessment of apps. We searched the Australian Google Play and iOS stores for English-language apps developed for people with BD. The comprehensiveness and quality of information was assessed against core psychoeducation principles and current BD treatment guidelines. Management tools were evaluated with reference to the best-practice resources for the specific area. General app features, and privacy and security were also assessed.

Of the 571 apps identified, 82 were included in the review. Of these, 32 apps provided information and the remaining 50 were management tools including screening and assessment (n=10), symptom monitoring (n=35), community support (n=4), and treatment (n=1). Not even a quarter of apps (18/82, 22%) addressed privacy and security by providing a privacy policy. Overall, apps providing information covered a third (4/11, 36%) of the core psychoeducation principles and even fewer (2/13, 15%) best-practice guidelines. Only a third (10/32, 31%) cited their information source. Neither comprehensiveness of psychoeducation information (r=-.11, P=.80) nor adherence to best-practice guidelines (r=-.02, P=.96) were significantly correlated with average user ratings. Symptom monitoring apps generally failed to monitor critical information such as medication (20/35, 57%) and sleep (18/35, 51%), and the majority of self-assessment apps did not use validated screening measures (6/10, 60%).

In general, the content of currently available apps for BD is not in line with practice guidelines or established self-management principles. Apps also fail to provide important information to help users assess their quality, with most lacking source citation and a privacy policy. Therefore, both consumers and clinicians should exercise caution with app selection. While mHealth offers great opportunities for the development of quality evidence-based mobile interventions, new frameworks for mobile mental health research are needed to ensure the timely availability of evidence-based apps to the public.

Nicholas J, Larsen ME, Proudfoot J, Christensen H. Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality. J Med Internet Res. 2015 Aug 17;17(8):e198. doi: 10.2196/jmir.4581.

Evidence Supports Medical Pot for Some Conditions, Not Others

August 22, 2015 by  
Filed under Featured, Research

Dennis Thompson reports:

Medical marijuana can be useful in treating chronic pain, but may be less effective for other conditions, a new analysis reveals.

A review of nearly 80 clinical trials involving medical marijuana or marijuana-derived drugs revealed moderately strong evidence to support their use in treating chronic pain, says a report published June 23 in the Journal of the American Medical Association.

The evidence also showed that the medications could help multiple sclerosis patients who suffer from spasticity, which involves sustained muscle contractions or sudden involuntary movements.

But the review found weaker support for the drugs’ use in treating sleep disorders; nausea or vomiting related to chemotherapy; for producing weight gain in people with HIV; or for reducing symptoms of Tourette syndrome, a nervous system disorder characterized by repetitive movements or sounds.

Read more on HealthDay.

More – and better – research is needed on the potential efficacy of medical marijuana. I’ve had a number of patients tell me that marijuana decreases their Tourette’s symptoms, but it’s not clear if the tics are actually decreasing or if the patients are just less aware of the tics or just less concerned about them.

Is Bipolar Disorder linked to higher intellect and creativity?

August 22, 2015 by  
Filed under Research

Childhood IQ and risk of bipolar disorder in adulthood: prospective birth cohort study
Daniel J. Smith, Jana Anderson, Stanley Zammit, Thomas D. Meyer, Jill P. Pell and Daniel Mackay
British Journal of Psychiatry Open, 2015, 1, 74–80.


Intellectual ability may be an endophenotypic marker for bipolar disorder.

Within a large birth cohort, we aimed to assess whether childhood IQ (including both verbal IQ (VIQ) and performance IQ (PIQ) subscales) was predictive of lifetime features of bipolar disorder assessed in young adulthood.

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large UK birth cohort, to test for an association between measures of childhood IQ at age 8 years and lifetime manic features assessed at age 22–23 years using the Hypomania Checklist-32 (HCL-32; n=1881 individuals). An ordinary least squares linear regression model was used, with normal childhood IQ (range 90–109) as the referent group. We adjusted analyses for confounding factors, including gender, ethnicity, handedness, maternal social class at recruitment, maternal age, maternal history of depression and maternal education.

There was a positive association between IQ at age 8 years and lifetime manic features at age 22–23 years (Pearson’s correlation coefficient 0.159 (95% CI 0.120–0.198), P>0.001). Individuals in the lowest decile of manic features had a mean full-scale IQ (FSIQ) which was almost 10 points lower than those in the highest decile of manic features: mean FSIQ 100.71 (95% CI 98.74–102.6) v. 110.14 (95% CI 107.79–112.50), P>0.001. The association between IQ and manic features was present for FSIQ, VIQ and for PIQ but was strongest for VIQ.

A higher childhood IQ score, and high VIQ in particular, may represent a marker of risk for the later development of bipolar disorder. This finding has implications for understanding of how liability to bipolar disorder may have been selected through generations. It will also inform future genetic studies at the interface of intelligence, creativity and bipolar disorder and is relevant to the developmental trajectory of bipolar disorder. It may also improve approaches to earlier detection and treatment of bipolar disorder in adolescents and young adults.

You can access the full-text article here (pdf).

Study: Math-Anxious Parents Can Hinder Children’s Math Achievement

August 22, 2015 by  
Filed under Research

KELO TV has a nice summary of some new research:

If math makes you anxious, you may now be able to blame your parents.

New research published in the Psychological Science, a journal of the Association of Psychology, found that children of math-anxious parents learned less math over the school year than those children of parents who were not math-anxious.

The study, led by two University of Chicago psychological scientists, also found that the children of math-anxious parents were more likely to be math-anxious themselves, but only when the math-anxious parents provided frequent help on the child’s math homework.

Read more on Keloland. If you want to obtain the research study itself, here’s the abstract:

Intergenerational Effects of Parents’ Math Anxiety on Children’s Math Achievement and Anxiety.
Maloney EA, Ramirez G2, Gunderson EA3, Levine SC4, Beilock SL4.
Psychol Sci. 2015 Aug 7.

A large field study of children in first and second grade explored how parents’ anxiety about math relates to their children’s math achievement. The goal of the study was to better understand why some students perform worse in math than others. We tested whether parents’ math anxiety predicts their children’s math achievement across the school year. We found that when parents are more math anxious, their children learn significantly less math over the school year and have more math anxiety by the school year’s end-but only if math-anxious parents report providing frequent help with math homework. Notably, when parents reported helping with math homework less often, children’s math achievement and attitudes were not related to parents’ math anxiety. Parents’ math anxiety did not predict children’s reading achievement, which suggests that the effects of parents’ math anxiety are specific to children’s math achievement. These findings provide evidence of a mechanism for intergenerational transmission of low math achievement and high math anxiety.

Coaxing Children With Selective Mutism to Find Their Voices

August 22, 2015 by  
Filed under Research

Catherine Saint Louis reports:

… The problem usually begins before age 5, and early intervention can help. Treatment usually involves cognitive behavioral therapy, with modifications for children who don’t talk to unknown adults — therapists included. If C.B.T. fails, drugs like Prozac may be prescribed in low doses.

But now researchers are taking a different tack: intensive, weeklong immersion programs, like this one run by Florida International University, in which selectively mute children are put through a variety of exercises to practice what frightens them most.

Classroom immersion may work more quickly than standard therapy, some experts say. And it exposes children to the need to speak in front of and with their peers.

Read more on the New York Times.

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