Dataset Information

Web-Based Self-Management Programs for Bipolar Disorder: Insights From the Online, Recovery-Oriented Bipolar Individualised Tool Project.

ABSTRACT: BACKGROUND:Bipolar disorder (BD) is a complex, relapsing mood disorder characterized by considerable morbidity and mortality. Web-based self-management interventions provide marked opportunities for several chronic mental health conditions. However, Web-based self-management programs targeting BD are underrepresented compared with programs targeting other psychiatric conditions. OBJECTIVE:This paper aims at facilitating future research in the area of self-management of BD and draws insights from the development of one such intervention-the Online, Recovery-Oriented Bipolar Individualised Tool (ORBIT)-that is aimed at improving the quality of life of people with BD. METHODS:We have discussed the opportunities and challenges in developing an engaging, evidence-based, safe intervention within the context of the following three nested domains: (1) intervention development; (2) scientific testing of the intervention; and (3) ethical framework including risk management. RESULTS:We gained the following insights across the three abovementioned overlapping domains: Web-based interventions can be optimized through (1) codesign with consumers with lived experience to ensure relevance and appropriateness to the target audience; (2) novel content development processes that iteratively combine evidence-based information with lived experience perspectives, capitalizing on multimedia (eg, videos) that the digital health space provides; and (3) incorporating Web-based communities to connect end users and promote constructive engagement by access to a Web-based coach. CONCLUSIONS:Self-management is effective in BD, even for those on the more severe end of the spectrum. While there are challenges to be aware of, guided self-management programs, such as those offered by the ORBIT project, which are specifically developed for Web-based delivery provide highly accessible, engaging, and potentially provocative treatments for chronically ill populations who may otherwise have never engaged with treatment. Key questions about engagement, effectiveness, and cost-effectiveness will be answered by the ORBIT project over the next 18 months.

SUBMITTER: Fletcher K

PROVIDER: S-EPMC6231852 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Web-Based Self-Management Programs for Bipolar Disorder: Insights From the Online, Recovery-Oriented Bipolar Individualised Tool Project.

Fletcher Kathryn K Foley Fiona F Murray Greg G

Journal of medical Internet research 20181024 10

<h4>Background</h4>Bipolar disorder (BD) is a complex, relapsing mood disorder characterized by considerable morbidity and mortality. Web-based self-management interventions provide marked opportunities for several chronic mental health conditions. However, Web-based self-management programs targeting BD are underrepresented compared with programs targeting other psychiatric conditions.<h4>Objective</h4>This paper aims at facilitating future research in the area of self-management of BD and draw ...[more]

PMID: 30355553

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Project description:BackgroundMembers of online bipolar disorder forums often report experiences of mood-stabilisation on the ketogenic diet, which has traditionally been used in the treatment of epilepsy. We examined the nature and extent of such reports.AimsTo investigate associations between a ketogenic diet and mood stabilisation among individuals with bipolar disorder.MethodWe undertook an observational analytic study of free-text comments in online forums about mood effects of dietary interventions (ketogenic, omega-3 enriched or vegetarian) classified by a priori categories of change in mood stabilisation in 274 people with bipolar disorder.ResultsThere were 141 (85.5%) free-text comments on ketogenic diets that reported a positive impact on mood stabilisation. Reports of significant mood stabilisation or remission of symptoms over a period were substantially higher for a ketogenic diet than for other diets (93/165, 56.4%, 95% CI 48.4-64.1) v. 14/94, 14.9%, 95% CI 8.4-23.7), odds ratio 7.4, 95% CI 3.8-14.1, P < 0.0001), many with detailed reports of the improvements experienced and several lasting for extended periods (months to years). Other reported associations included fewer episodes of depression (in 41.2%, 95% CI 30.6-52.4 of individuals); improved clarity of thought and speech (28.2%, 95% CI 19.0-39.0); increased energy (25.9, 95% CI 17.0-36.5); and weight loss (25.9%, 95% CI 17.0-36.5).ConclusionsDespite the inherent limitations of the observational data based on self-reports posted online, the association strength and reports of sustained benefit support a hypothesis of a ketogenic diet being associated with beneficial effects on mood stabilisation. Caution should be exercised in interpreting this data until a controlled trial can be carried out to examine this hypothesis. These preliminary observations are generally consistent with a mitochondrial dysfunction component to bipolar disorder aetiology with ketones bypassing a block between glycolysis and the tricarboxylic acid cycle.Declaration of interestNone.

Project description:MotivationLife stories of diseased and healthy individuals are abundantly available on the Internet. Collecting and mining such online content can offer many valuable insights into patients' physical and emotional states throughout the pre-diagnosis, diagnosis, treatment and post-treatment stages of the disease compared with those of healthy subjects. However, such content is widely dispersed across the web. Using traditional query-based search engines to manually collect relevant materials is rather labor intensive and often incomplete due to resource constraints in terms of human query composition and result parsing efforts. The alternative option, blindly crawling the whole web, has proven inefficient and unaffordable for e-health researchers.ResultsWe propose a user-oriented web crawler that adaptively acquires user-desired content on the Internet to meet the specific online data source acquisition needs of e-health researchers. Experimental results on two cancer-related case studies show that the new crawler can substantially accelerate the acquisition of highly relevant online content compared with the existing state-of-the-art adaptive web crawling technology. For the breast cancer case study using the full training set, the new method achieves a cumulative precision between 74.7 and 79.4% after 5 h of execution till the end of the 20-h long crawling session as compared with the cumulative precision between 32.8 and 37.0% using the peer method for the same time period. For the lung cancer case study using the full training set, the new method achieves a cumulative precision between 56.7 and 61.2% after 5 h of execution till the end of the 20-h long crawling session as compared with the cumulative precision between 29.3 and 32.4% using the peer method. Using the reduced training set in the breast cancer case study, the cumulative precision of our method is between 44.6 and 54.9%, whereas the cumulative precision of the peer method is between 24.3 and 26.3%; for the lung cancer case study using the reduced training set, the cumulative precisions of our method and the peer method are, respectively, between 35.7 and 46.7% versus between 24.1 and 29.6%. These numbers clearly show a consistently superior accuracy of our method in discovering and acquiring user-desired online content for e-health research.Availability and implementationThe implementation of our user-oriented web crawler is freely available to non-commercial users via the following Web site: http://bsec.ornl.gov/AdaptiveCrawler.shtml. The Web site provides a step-by-step guide on how to execute the web crawler implementation. In addition, the Web site provides the two study datasets including manually labeled ground truth, initial seeds and the crawling results reported in this article.

Dataset Information

Web-Based Self-Management Programs for Bipolar Disorder: Insights From the Online, Recovery-Oriented Bipolar Individualised Tool Project.

Publications

Web-Based Self-Management Programs for Bipolar Disorder: Insights From the Online, Recovery-Oriented Bipolar Individualised Tool Project.

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