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Register a new userThe Relationship between Major Depression Symptom Severity and Sleep Collected Using a Wristband Wearable Device: Multi-centre Longitudinal Observational Study
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Research in mental health has implicated sleep pathologies with depression. However, the gold standard for sleep assessment, polysomnography, is not suitable for long-term, continuous, monitoring of daily sleep, and methods such as sleep diaries rely on subjective recall, which is qualitative and inaccurate. Wearable devices, on the other hand, provide a low-cost and convenient means to monitor sleep in home settings. The main aim of this study was to devise and extract sleep features, from data collected using a wearable device, and analyse their correlation with depressive symptom severity and sleep quality, as measured by the self-assessed Patient Health Questionnaire 8-item. Daily sleep data were collected passively by Fitbit wristband devices, and depressive symptom severity was self-reported every two weeks by the PHQ-8. The data used in this paper included 2,812 PHQ-8 records from 368 participants recruited from three study sites in the Netherlands, Spain, and the UK.We extracted 21 sleep features from Fitbit data which describe sleep in the following five aspects: sleep architecture, sleep stability, sleep quality, insomnia, and hypersomnia. Linear mixed regression models were used to explore associations between sleep features and depressive symptom severity. The z-test was used to evaluate the significance of the coefficient of each feature. We tested our models on the entire dataset and individually on the data of three different study sites. We identified 16 sleep features that were significantly correlated with the PHQ-8 score on the entire dataset. Associations between sleep features and the PHQ-8 score varied across different sites, possibly due to the difference in the populations.
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The Bluetooth sensor embedded in mobile phones provides an unobtrusive, continuous, and cost-efficient means to capture individuals proximity information, such as the nearby Bluetooth devices count (NBDC). The continuous NBDC data can partially reflect individuals behaviors and status, such as social connections and interactions, working status, mobility, and social isolation and loneliness, which were found to be significantly associated with depression by previous survey-based studies. This paper aims to explore the NBDC datas value in predicting depressive symptom severity as measured via the 8-item Patient Health Questionnaire (PHQ-8). The data used in this paper included 2,886 bi-weekly PHQ-8 records collected from 316 participants recruited from three study sites in the Netherlands, Spain, and the UK as part of the EU RADAR-CNS study. From the NBDC data two weeks prior to each PHQ-8 score, we extracted 49 Bluetooth features, including statistical features and nonlinear features for measuring periodicity and regularity of individuals life rhythms. Linear mixed-effect models were used to explore associations between Bluetooth features and the PHQ-8 score. We then applied hierarchical Bayesian linear regression models to predict the PHQ-8 score from the extracted Bluetooth features. A number of significant associations were found between Bluetooth features and depressive symptom severity. Compared with commonly used machine learning models, the proposed hierarchical Bayesian linear regression model achieved the best prediction metrics, R2= 0.526, and root mean squared error (RMSE) of 3.891. Bluetooth features can explain an extra 18.8% of the variance in the PHQ-8 score relative to the baseline model without Bluetooth features (R2=0.338, RMSE = 4.547).
With more than 300 million people depressed worldwide, depression is a global problem. Due to access barriers such as social stigma, cost, and treatment availability, 60% of mentally-ill adults do not receive any mental health services. Effective and efficient diagnosis relies on detecting clinical symptoms of depression. Automatic detection of depressive symptoms would potentially improve diagnostic accuracy and availability, leading to faster intervention. In this work, we present a machine learning method for measuring the severity of depressive symptoms. Our multi-modal method uses 3D facial expressions and spoken language, commonly available from modern cell phones. It demonstrates an average error of 3.67 points (15.3% relative) on the clinically-validated Patient Health Questionnaire (PHQ) scale. For detecting major depressive disorder, our model demonstrates 83.3% sensitivity and 82.6% specificity. Overall, this paper shows how speech recognition, computer vision, and natural language processing can be combined to assist mental health patients and practitioners. This technology could be deployed to cell phones worldwide and facilitate low-cost universal access to mental health care.
Understanding the sleep quality and architecture is essential to human beings health, which is usually represented using multiple sleep stages. A standard sleep stage determination requires Electroencephalography (EEG) signals during the expensive and labor-intensive Polysomnography (PSG) test. To overcome this inconvenience, cardiorespiratory signals are proposed for the same purpose because of the easy and comfortable acquisition by simplified devices. In this paper, we leverage our low-cost wearable multi-sensor system to acquire the cardiorespiratory signals from subjects. Three novel features are designed during the feature extraction. We then apply a Bi-directional Recurrent Neural Network architecture with Long Short-term Memory (BLSTM) to predict the four-class sleep stages. Our prediction accuracy is 80.25% on a large public dataset (417 subjects), and 80.75% on our 32 enrolled subjects, respectively. Our results outperform the previous works which either used small data sets and had the potential over-fitting issues, or used the conventional machine learning methods on large data sets.
Background: The evolution of symptoms over time is at the heart of understanding and treating mental disorders. However, a principled, quantitative framework explaining symptom dynamics remains elusive. Here, we propose a Network Control Theory of Psychopathology allowing us to formally derive a theoretical control energy which we hypothesize quantifies resistance to future symptom improvement in Major Depressive Disorder (MDD). We test this hypothesis and investigate the relation to genetic and environmental risk as well as resilience. Methods: We modelled longitudinal symptom-network dynamics derived from N=2,059 Beck Depression Inventory measurements acquired over a median of 134 days in a sample of N=109 patients suffering from MDD. We quantified the theoretical energy required for each patient and time-point to reach a symptom-free state given individual symptom-network topology (E 0 ) and 1) tested if E 0 predicts future symptom improvement and 2) whether this relationship is moderated by Polygenic Risk Scores (PRS) of mental disorders, childhood maltreatment experience, and self-reported resilience. Outcomes: We show that E 0 indeed predicts symptom reduction at the next measurement and reveal that this coupling between E 0 and future symptom change increases with higher genetic risk and childhood maltreatment while it decreases with resilience. Interpretation: Our study provides a mechanistic framework capable of predicting future symptom improvement based on individual symptom-network topology and clarifies the role of genetic and environmental risk as well as resilience. Our control-theoretic framework makes testable, quantitative predictions for individual therapeutic response and provides a starting-point for the theory-driven design of personalized interventions. Funding: German Research Foundation and Interdisciplinary Centre for Clinical Research, Munster
One major challenge in the medication of Parkinsons disease is that the severity of the disease, reflected in the patients motor state, cannot be measured using accessible biomarkers. Therefore, we develop and examine a variety of statistical models to detect the motor state of such patients based on sensor data from a wearable device. We find that deep learning models consistently outperform a classical machine learning model applied on hand-crafted features in this time series classification task. Furthermore, our results suggest that treating this problem as a regression instead of an ordinal regression or a classification task is most appropriate. For consistent model evaluation and training, we adopt the leave-one-subject-out validation scheme to the training of deep learning models. We also employ a class-weighting scheme to successfully mitigate the problem of high multi-class imbalances in this domain. In addition, we propose a customized performance measure that reflects the requirements of the involved medical staff on the model. To solve the problem of limited availability of high quality training data, we propose a transfer learning technique which helps to improve model performance substantially. Our results suggest that deep learning techniques offer a high potential to autonomously detect motor states of patients with Parkinsons disease.
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