PROJECT NEWSLETTER - ISSUE NO.

1, JULY 2009

www.BipolarLab.com

P025, DEPARTMENT OF HEALTH SERVICE AND POPULATION RESEARCH,INSTITUTE OF PSYCHIATRY,

KING’S COLLEGE LONDON, DE CRESPIGNY PARK ROAD, SE5 8AF, LONDON
GREETINGS...
to all of you my beloved and brave
participants of the eMonitoring
p r o j e c t . I s h o u l d h ave p u t a
newsletter together a long time ago,
but it is only now that I am getting
busy with writing up.

The study for now is completed and I

ought to say that we did an
impressive amount of work together.
It has been a long but a challenging
and interesting journey in more ways
than you can imagine.

Most of you had predicted I would

have an interesting time ahead
dealing with the masses of data we
collected. As usual you were right. I
am spending days and nights still
putting all the databases together.

WHAT WE DID...
For starters we did a study together
that most people had predicted would
not be possible to do. We completed
one of the most comprehensive
symptom monitoring prog rams
possible ever done with people who
have a bipolar disorder. Full-stop!!!
All in all, out of the 45 people
recruited, 37 of you successfully
completed most of the study. Yes, you
remember correctly, we did 3 months
o f d a i ly a n d w e e k ly s y mp t o m
monitoring! But read on to learn
more...
Looking at the future...
So what else lies ahead? Well Preliminary analyses indicate
there are 4 interesting studies that at least half of the group
that need to be written as a (even though as a group it looks
result of our efforts. The first almost symptom free) spends a
study will look at the entire considerable amount of time
with sub-syndromal depressive
symptomatology of the group. It
symptoms. This has been shown
will give us an idea of what sort
before but at least we know we
of symptoms are more prevalent
are on the same track. In
when people are relatively well -
contrast to previous studies, we
we call these “sub-syndromal
can look at these symptoms in
symptoms”. It will also look at
greater detail and can determine
how much time people spend
far more accurately
experiencing these symptoms.

CHEWY CHAN (aka GBOT) was our second

GEORGE SALAMINIOS started as a junior
psychology intern from Brunel university and
was instrumental in helping throughout the
project. Having achieved a 1st class honours
degree, he is now completing an MSc at UCL and
is getting ready for his Greek military service.
junior psychology intern from Brunel
university. Despite her worries she also
achieved a 1st class honours degree. She is
currently looking for jobs in human resources.
Chewy (rightly) thinks I am a Greek “Ogre”
but at least she loves travelling to Greece.
AGAZI FESSEHAIE was our third and final
student intern from Brunel university. Some of
you remember his “reminder” emails. He also
completed successfully his psychology degree and
is currently thinking of going into counselling
psychology.

1
important clinical variables such as
symptom peaks, mood switches, and
overall symptom variability. These OUR MECHANICS
are likely to become future
Dr Kristof Van Laerhoven
treatment targets, especially if we and his students are working
find that they influence the clinical behind the scenes to develop the
course of Bipolar disorder. uber-actiwatch from their evil
research lab in Germany. It will not
The second study will look at our only monitor your activity, but it
will also know what you do! They
little baby electronic diary
sure aim high! Yes, it is them!
iMonitor (http://myiMonitor.com).
This was something that we
developed especially for the needs of
the current project. It is important
for other researchers and clinicians
to know how this software was
developed and how it performs as a
symptom monitoring tool in
comparison with other established
Andreas Soupianas is the man
methods.
behind iMonitor. A childhood friend
and top programmer from Athens. He
Preliminary analyses indicate that
did all his work for free in order to
most of the items included in help his friend complete his project. We
iMonitor appear to measure what owe him a big manic thank you!
they are meant to measure. I would
have liked to see better
The third study will look at your data I believe to get an idea. These
“correlations” with the clinical
much hated actiwatch and also at activity sensors should be able to
measures (our interviews) but
your much beloved pedometer. pick up the more severe symptom
iMonitor is just as “bad” as other
Approximately half of you used an peaks or changes. The application of
daily symptom monitoring tools that
actiwatch in order to monitor your these sensors in monitoring bipolar
rely on self-report. More analyses
sleep and activity levels. The other disorder is really our first step
are really needed to determine its
h a l f u s e d a p e d o m e t e r w h i ch towards moving away from self-
“psychometric value” and, most
c o n t a i n e d a r a t h e r s i m i l a r report methods. Really who wants to
importantly, to see whether what
accelerometer sensor but costed keep a mood diary all the time?
was measured in there can give us
much less. We need to figure out how I don’t.
an idea in predicting people’s clinical
good these gadgets are for
course. This is what we call
monitoring people’s symptoms and The final and fourth study will
“predictive validity”, which will be
mood states, more or less like we are investigate the different predictors
the most significant test of iMonitor.
doing with iMonitor. We have enough of the course. It will be important to

Professor Tom Craig acts as a sneak peak at our clinical data

secondary supervisor. He has been
instrumental in helping me to clarify
my research questions and finalise Days monitored
the outline of my thesis. Professor 2681
Craig has an interest in psychosocial
Weeks targeted
766
predictors of mood disorders. Weeks assessed
519
Both of them have conducted some
Weeks missed
247
Professor Dinesh Bhugra has made of the most important studies in the
area. # of Symptom peak
the completion of the second part of s 126
the study possible. His moral and # of depressive peak
Hence, the attachment project
financial support are helping to see s 24
(www.bipolarlab.com/attachment) # of manic peaks
this study through. He is currently 3
and the childhood experiences
acting President of the Royal College
interview most of you participated in # of subsyndromal
peaks 101
of Psychiatry, along with being a
at a later stage of the project. # of episodes
Professor of Mental Health & ???
Cultural Psychiatry at the Institute. This study is almost over too.

2
 The Final Follow-up?
psychological models that make
CHRONORECORD STUDY
predictions about Bipolar disorder
and its course. These are going to be Some of you used ChronoRecord,
a valuable set of preliminary studies
our desktop pc based electronic
diary. Your efforts are already
to develop the models further and bearing fruits as we have the first
improve the psychological therapies publication out by Dr Bauer
that use these models to prevent (German Psychiatrist), Tasha Glenn
relapses in Bipolar disorder. We have (ChronoRecord developer) and
3 MSc students who are working on other important researchers in
the field (yes, they kindly included
these studies as part of their theses.
me too).
Angeline, Kemi and Rachel will be
see and establish whether the writing more about their projects in The study combined data from
ChronoRecord centers across the
presence and variability of such sub- a forthcoming newsletter.
world and looked at the influence
syndromal symptoms can predict of climate on mood.
who becomes unwell and who stays Dr Emil Kraepelin (pictured left),
well. We have already gathered some the German father of our modern
Contrary to popular beliefs, at
least in this study and our bipolar
of our so called “relapse data” and western psychiatry, who also made sample, climate does not seem to
that’s why we had the follow ups. But t h e d i s t i n c t i o n b e t w e e n affect your mood! See the
ideally we need to have one more schizophrenia and manic depressive attached article-http://is.gd/BFOF
illness, was a great advocate of
and final follow up. Usually to
daily symptom monitoring
answer such questions, the longer IN THIS FIRST NEWSLE
methods and the prospective TTER,
the follow-up time, the better one can ...I hope you all learned
investigation of Bipolar disorder. something
determine such things. Ideally, I new about what we
He did it all by himself. He did not did an d what we
would have liked you all to have are doing with th
bother with coaching his patients e res ea rch you
stayed well, and to have had no participated. Your
contribution has
really or had to rely on self-report, been invaluable. I wi
relapses. But we know that Bipolar ll do my best to
but that was a different era and ke ep you informed with
disorder is a recurring condition and more papers
m a ny o f h i s p a t i e n t s w e r e and newsletters. We
r e l a p s e s a r e t h e r e . H o w e v e r, are also looking
chronically unwell and were forward to seeing yo
whether you had them or not, it will u for one more
inpatients. Nowadays and thanks time to conclude all
still be important to know. You will the follow-ups for
to our modern treatments things my PhD thesis. There
all get a final invitation letter/email/ will be lunch,
have changed. We can do studies and greek treats as
call with the dates of your last follow us ual! As they
like the one we did all together, say, “beware of the
up. If you can gather your diaries Gr eek s bearing
going through our ups and downs gifts”! But we all like
and other notes to help us best the m!
but at the same time holding still
determine what has happened since
a n d g o i ng th r ough all the Yours truly,
then, you will make our lives a lot
assessments. I am sure he would Yanni Malliaris
easier.
have been proud of us all.

More studies to come...in reality See Dr Lieberman’s free web

with all the data that we have reincarnation of Dr Kraepelin’s
+44-207-193-5746
gathered there will be many more Life-Chart:
yanni@bipolarlab.co
studies to come. Most of the other m
studies will test different www.moodchart.org
vulnerability factors from

JON’S MOODSCOPE PROJECT HELLENIC BIPOLAR ORGANISATION

Also remember to check Jon’s MoodScope
project. Jon participated like you in the
eMonitoring project and he is public about his
experience with Bipolar disorder. Not only
did he do an excellent job at it, but was also
further inspired to develop his own mood
monitoring system. It is best for mild mood
disorders and “normal” mood fluctuations.
www.moodscope.com
DR MIKE HADJULIS, a friendly shrink, was
there for me during the study helping in the
background to keep my head together as well as to
make sure we get all our diagnoses right. He is
assisting with the more analytical matters of the
study and the clinical value of our results.
Last but not least, along with a group of
colleagues over the last year and a half, I
founded the first MDF-Like organisation for
Bipolar patients, their relatives, friends, and
professionals in Greece. I founded this in my
father’s memory who had the illness and
suffered much from it. We hope it grows and
one day becomes as big and helpful to
Bipolar people as the UK group. If you can
read Greek, it’s all here:
www.bipolar.gr