Notwendigkeit für Symptom-Monitoring und Frühwarnzeichenerkennung bipolarer Episoden durch eine App? – Ansichten von PatientInnen und Angehörigen zu e-health Bedarf

Zusammenfassung

Hintergrund Der Beginn und Frühwarnzeichen von Krankheitsepisoden der bipolaren Störung werden von Betroffenen häufig erst spät erkannt. Je früher eine Krankheitsepisode behandelt wird, desto prognostisch günstiger ist der Verlauf. Die Symptomüberwachung per Smartphone-Applikation (App) könnte eine innovative Möglichkeit darstellen, um Frühwarnzeichen zu erkennen und schneller mit den richtigen Strategien darauf zu reagieren. Das Ziel dieser Studie war es zu evaluieren, ob PatientInnen mit bipolarer Erkrankung und deren Angehörige eine technische Unterstützung durch eine App als sinnvoll und praktikabel in der Früherkennung sowie in der Behandlung erachten.

Methoden In der vorliegenden Studie wurden 51 PatientInnen mit bipolarer Störung und 28 Angehörige befragt. Es wurde ermittelt, ob die ProbandInnen Frühwarnzeichen in Form von Verhaltensänderungen derzeit subjektiv ausreichend und rechtzeitig wahrnehmen können. Zudem wurde erhoben, ob die StudienprobandInnen ein Smartphone als Behandlungsunterstützung nutzen würden.

Ergebnisse Obwohl sich 94,1% der befragten PatientInnen und 78.6% der Angehörigen gut über die Erkrankung informiert fühlten, waren 13,7% beziehungsweise 35,7% mit den derzeitigen Behandlungsmöglichkeiten nicht zufrieden. Frühwarnzeichen jeder depressiven Entwicklung wurden von 25,5% der PatientInnen wahrgenommen (Angehörige 10,7%). Jede (hypo)manische Entwicklung wurde lediglich von 11,8% der PatientInnen wahrgenommen (Angehörige 7,1%). 88,2% der PatientInnen und 85,7% ihrer Angehörigen bemerkten zu Beginn einer Depression und 70,6% beziehungsweise 67,9% zu Beginn einer (hypo)manischen Episode wiederkehrend dieselben Symptome (insbesondere Veränderungen der körperlichen Aktivität, des Kommunikationsverhaltens und des Schlaf-Wach-Rhythmus). 84,3% der PatientInnen und 89,3% der Angehörigen gaben an, dass sie eine technische Unterstützung, welche auf Veränderungen in Stimmungs- und Aktivitätslage aufmerksam macht, als sinnvoll erachten und dass sie eine Smartphone-App für die Behandlung nutzen würden.

Diskussion Die derzeitigen Möglichkeiten zur Wahrnehmung von Frühwarnzeichen einer depressiven oder (hypo)manischen Episode bei bipolarer Störung sind klinisch unzureichend. Bei Betroffenen und Angehörigen besteht der Wunsch nach innovativen, technischen Unterstützungen. Die rechtzeitige Früherkennung von Krankheitssymptomen, die sich oft in Veränderungen von Verhaltens- oder Aktivitätsmustern äußert, ist für den Verlauf essentiell. Apps könnten hierbei durch objektive, kontinuierliche und individuelle Datenerhebung in der Zukunft für die klinische Behandlung und die Forschung genutzt werden.

Abstract

Background The onset and early warning signs of episodes of bipolar disorder are often realized late by those affected. The earlier an incipient episode is treated, the more prognostically favorable the course will be. Symptom monitoring via smartphone application (app) could be an innovative way to recognize and react to early warning signs more swiftly. The aim of this study was to find out whether patients and their relatives consider technical support through an app to be useful and practical in the early warning sign detection and treatment.

Methods In the present study, 51 patients with bipolar disorder and 28 relatives were interviewed. We gathered information on whether participants were able to perceive early warning signs in form of behavioral changes sufficiently and in a timely fashion and also whether they would use an app as treatment support tool.

Results Although 94.1% of the surveyed patients and 78.6% of their relatives felt that they were well informed about the disease, 13.7% and 35.7%, respectively were not fully satisfied with the current treatment options. Early warning signs of every depressive development were noticed by 25.5% of the patients (relatives 10.7%). Every (hypo)manic development was only noticed by 11.8% of the patients (relatives 7.1%); 88.2% of the patients and 85.7% of the relatives noticed the same symptoms recurrently at the beginning of a depression and 70.6% and 67.9%, respectively, at the beginning of a (hypo)manic episode (in particular changes in physical activity, communication behavior and the sleep-wake rhythm). 84.3% of the patients and 89.3% of the relatives stated that they considered technical support that draws attention to mood and activity changes as useful and that they would use such an app for the treatment.

Discussion The current options for perceiving early warning signs of a depressive or (hypo)manic episode in bipolar disorder are clinically inadequate. Those affected and their relatives desire innovative, technical support. Early detection of symptoms, which often manifest themselves in changes in behavior or activity patterns, is essentiell for managing the course of bipolar disorder. In the future, smartphone apps could be used for clinical treatment and research through objective, continuous and

Schlüsselwörter

mobile-health - Bipolare Störung - Smartphone App - Symptom-Monitoring - Frühwarnzeichen - Früherkennung

Key words

mobile health - bipolar disorder - smartphone app - symptom monitoring - early warning signs

Publication History

Received: 18 March 2020

Accepted: 03 May 2021

Article published online:
06 August 2021

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