scholarly journals Similarity Matrix-Based Anomaly Detection for Clinical Intervention

Author(s):  
Ryan D’Mello ◽  
Jennifer Melcher ◽  
John Torous

Abstract The use of digital phenotyping methods in clinical care has allowed for improved investigation of spatiotemporal behaviors of patients. Moreover, detecting abnormalities in mobile sensor data patterns can be instrumental in identifying potential changes in symptomology. We propose a method that temporally aligns sensor data in order to achieve interpretable measures of similarity. These computed measures can then be used for anomaly detection, baseline routine computation, and trajectory clustering. In addition, we apply this method on a study of 695 college participants, as well as on a patient with worsening anxiety and depression. With varying temporal constraints, we find mild correlations between changes in routine and clinical scores. Furthermore, in our experiment on an individual with elevated depression and anxiety, we are able to cluster GPS trajectories, allowing for improved understanding and visualization of routines with respect to symptomology. In the future, we aim to apply this method on individuals that undergo data collection for longer periods of time, thus allowing for a better understanding of long-term routines and signals for clinical intervention.

2021 ◽  
Author(s):  
◽  
Amy O'Connell

<p>Serotonin is an important neurotransmitter that regulates a range of processes within the brain and is implicated in several psychiatric disorders. In addition, serotonin acts as a developmental signal during critical periods of prenatal development, influencing processes such as neuronal proliferation, migration, and synaptogenesis (Gaspar et al., 2003). The serotonin transporter (5- HTT) plays a key role in regulating extracellular serotonin levels and is the main target of selective-serotonin reuptake inhibitors (SSRIs), a class of drugs that have anti-anxiety and anti- depressive activity. SSRIs cause an acute increase in extracellular serotonin and are commonly prescribed as a treatment for depression and anxiety during pregnancy (Tran & Robb, 2015). Given that these drugs alter serotonin transmission and can pass to the developing fetus via the placenta, it is vital that the outcomes of prenatal SSRI exposure are investigated. In humans, a genetic variant of the gene that codes for the 5-HTT (SLC6A4) has been linked to increased risk for developing depression and anxiety (Caspi et al., 2003). The functional consequences of this genetic polymorphism are life-long alterations in 5-HTT activity, resulting in increased extracellular levels of serotonin (Nakamura et al., 2000). Given prenatal SSRI exposure results in a time-locked blockade of 5-HTT during critical periods of development, it follows that alterations in serotonin during development might similarly result in enhanced risk for depression and anxiety later in life. Outcomes in children prenatally exposed to SSRIs are difficult to study due to confounds of pre- existing maternal depression. Therefore, the current thesis presents two experiments that aimed to further investigate the role of altered extracellular serotonin levels during development in an animal model. Experiment one aimed to develop a method of voluntary oral administration of the SSRI fluoxetine to pregnant rat dams. This method was then applied in experiment two to create a time-locked blockade of 5-HTT during critical periods of development in an animal model of life-long 5-HTT blockade. The aim of experiment two was to directly assess the contribution of short- and long-term 5-HTT blockade on anxiety and depression phenotypes in adult male offspring. In addition, maternal behaviour was assessed to determine whether fluoxetine treatment had an influence on mother-pup interactions that could confound results. To test for anxiety and depression phenotypes, the novel affective disorder test (ADT) was used to assess anxiety behaviour and the deficits in anticipatory pleasure indicative of anhedonia. In the current study, fluoxetine treatment did not have an effect on litter outcomes or mother-pup interactions. Crucially, no significant group differences were found indicating that neither short- nor long- term blockade of 5-HTT resulted in increased anxiety- or depressive-like behaviours in the current experiment. However, limitations with methodological design limit the translatability of these results to the broader literature, and validation of the ADT is required before these results can be generalised beyond this thesis.</p>


Author(s):  
MARIAM AHMED ◽  
HANA MORRISSEY ◽  
PATRICK ANTHONY BALL

This review aims to understand the co-existence of mental ill-health and heart failure and if this comorbidity affects patient self-care motivation and overall health outcomes. Databases searched were; PubMed®, Google® scholar and Science Direct® for studies related to heart failure, heart failure and mental health, depression and anxiety. Eleven articles were identified and reviewed. There were two studies disagreed with the theory that the mental ill-health and heart failure has disease modification and worsen patient health outcomes, three studies concluded that only anxiety has effect, five studies concluded that both anxiety and depression have effect, six studies concluded that depression only has effect but all eleven stated that more research is required. Recent theories on depression and cardiovascular disease comorbidity and the effect mental ill-health have on medication adherence in heart failure patients was discussed. People with long-term physical illnesses may suffer further complications to their health if they develop mental illness; increasing the cost of their care by an average of 45%, however, in the majority of these cases, the mental issues neither diagnosed nor treated. This review explored the link between cardiovascular disease (CVD) and mental ill health; and how comorbidity of the two conditions affects patients’ adherence to therapy behaviour. It was concluded that while the link between mental ill health and heart failure (HF) is recognized, studies that may be used as a basis of evidence to confirm this link are scarce.


2018 ◽  
Vol 10 (11) ◽  
pp. 144
Author(s):  
Carmen A. Sierra Llamas ◽  
Rafael E. Donado Castillo ◽  
Gustavo Aroca ◽  
Santos Ángel Depine ◽  
Gladys Gaviria ◽  
...  

The purpose of this study is to determine the levels of anxiety and depression in patients aged between 18 and 70 years, hospitalized with chronic kidney disease in a clinic entity of the city of Barranquilla. The type of research is descriptive, presenting the information through the indicators and statistical tables, the Hospital Scale of Anxiety and Depression of, Zigmond &amp; Smith (1983), which evaluates the detection of depressive and anxious disorders in the non-psychiatric hospital context. The application of the Scale was performed in the hospital entity of the city of Barranquilla to 50 patients with Chronic Kidney Disease. The results they are beneficial in the short term, because they create new research proposals applied to another population group diagnosed with chronic diseases, especially for the evaluation and intervention in the area of health psychology. In the long term, new theories, methods of intervention and evaluation applied to the population of patients with chronic kidney disease will be studied. In the same way, the results show marked trends related to depression, an aspect that is consistent with the deterioration that affects the individual in the course of the disease and also show a positive correlation of the study variables, depression and anxiety disorders in patients with CKD can be due to a symptomatology or consequence of psychological burnout.


2021 ◽  
Author(s):  
◽  
Amy O'Connell

<p>Serotonin is an important neurotransmitter that regulates a range of processes within the brain and is implicated in several psychiatric disorders. In addition, serotonin acts as a developmental signal during critical periods of prenatal development, influencing processes such as neuronal proliferation, migration, and synaptogenesis (Gaspar et al., 2003). The serotonin transporter (5- HTT) plays a key role in regulating extracellular serotonin levels and is the main target of selective-serotonin reuptake inhibitors (SSRIs), a class of drugs that have anti-anxiety and anti- depressive activity. SSRIs cause an acute increase in extracellular serotonin and are commonly prescribed as a treatment for depression and anxiety during pregnancy (Tran & Robb, 2015). Given that these drugs alter serotonin transmission and can pass to the developing fetus via the placenta, it is vital that the outcomes of prenatal SSRI exposure are investigated. In humans, a genetic variant of the gene that codes for the 5-HTT (SLC6A4) has been linked to increased risk for developing depression and anxiety (Caspi et al., 2003). The functional consequences of this genetic polymorphism are life-long alterations in 5-HTT activity, resulting in increased extracellular levels of serotonin (Nakamura et al., 2000). Given prenatal SSRI exposure results in a time-locked blockade of 5-HTT during critical periods of development, it follows that alterations in serotonin during development might similarly result in enhanced risk for depression and anxiety later in life. Outcomes in children prenatally exposed to SSRIs are difficult to study due to confounds of pre- existing maternal depression. Therefore, the current thesis presents two experiments that aimed to further investigate the role of altered extracellular serotonin levels during development in an animal model. Experiment one aimed to develop a method of voluntary oral administration of the SSRI fluoxetine to pregnant rat dams. This method was then applied in experiment two to create a time-locked blockade of 5-HTT during critical periods of development in an animal model of life-long 5-HTT blockade. The aim of experiment two was to directly assess the contribution of short- and long-term 5-HTT blockade on anxiety and depression phenotypes in adult male offspring. In addition, maternal behaviour was assessed to determine whether fluoxetine treatment had an influence on mother-pup interactions that could confound results. To test for anxiety and depression phenotypes, the novel affective disorder test (ADT) was used to assess anxiety behaviour and the deficits in anticipatory pleasure indicative of anhedonia. In the current study, fluoxetine treatment did not have an effect on litter outcomes or mother-pup interactions. Crucially, no significant group differences were found indicating that neither short- nor long- term blockade of 5-HTT resulted in increased anxiety- or depressive-like behaviours in the current experiment. However, limitations with methodological design limit the translatability of these results to the broader literature, and validation of the ADT is required before these results can be generalised beyond this thesis.</p>


2020 ◽  
Vol 11 ◽  
Author(s):  
Xiangyu Kong ◽  
Fanyang Kong ◽  
Kailian Zheng ◽  
Min Tang ◽  
Yi Chen ◽  
...  

The COVID-19 epidemic has caused increasing public panic and mental health stress. In this study, we explore the prevalence and factors linked to anxiety and depression in hospitalized patients with COVID-19. A total of 144 patients diagnosed with COVID-19 underwent depression and anxiety assessment by using the Hospital Anxiety and Depression Scale (HADS). Social support level was also evaluated by the Perceived Social Support Scale (PSSS) at admission. Results showed that gender, age, oxygen saturation, and social support were associated with anxiety for COVID-19 patients. In addition, age, family infection with SARS-CoV-2, and social support were the risk factors associated with depression. Moreover, we designed a psychological–behavioral intervention (PBI) program that included psychological support and breathing exercises, and explored its effects on patients with COVID-19. Of the 144 participants, 26 patients with both anxiety and depression symptoms (cutoff score of ≥8 on HADS-A and HADS-D) were randomly assigned to the intervention group and the control group at a 1:1 ratio. After 10-day treatment, the HADS scores of depression and anxiety were significantly reduced in the intervention group, and PSSS scores were also significantly improved. However, no significant differences in HADS and PSSS scores between pre- and post-treatment were found in the control group. Our findings indicate that mental concern and appropriate intervention are essential parts of clinical care for COVID-19 patients.


2020 ◽  
Vol 6 (2) ◽  
pp. 213-234
Author(s):  
Romes Bittencourt Nogueira de Sousa ◽  
◽  
Carini Silva da Silva ◽  
Marcos Antônio Ferreira Filho ◽  
Gustavo Rodrigues Pedrino ◽  
...  

The non-linear analysis of the heart rate variability (HRV) is a potential correlation tool between physiological and emotional states. The aim of this study was correlate changes in non-linear parameters of the HRV with anxiety and depression indices in higher education entrants from Federal University of Goiás (UFG). To record HRV, the Polar Frequency Metermodel Polar® RS800cx (Electro Oi, Finland) was used. To analyze the levels of depression, the Beck Depression Inventory-I (BDI) was used, and for analysis of anxiety, the Inventories of State and Trace (IDATE T and E). Altogether, 50 (19.4±2.48 years) volunteers participated in the study. The scores of the depression and anxiety inventories indicated that the public had low and moderate indices of both conditions, respectively. Statistically significant correlations were found between the SD2 parameter (from the Poincaré plot in the HRV analysis), entropy data (ApEn and SampEn) and fractal property (DFA: α1) and trait and state anxiety levels. Although ApEn e SampEn still do not have well-defined physiological correspondences, DFA: α1 has been associated with parasympathetic modulation of heart rate. Therefore, it is concluded that chronic negative emotional states, such as anxiety and humor disorders, can be accompanied by parasympathetic increase in HRV, so the organism would be able to not wear out against long-term stressors. New studies are necessary to understand the physiological and evolutional bases of depression and anxiety.


2020 ◽  
Author(s):  
Matija Sestan-Pesa ◽  
Marya Shanabrough ◽  
Tamas L. Horvath ◽  
Maria Consolata Miletta

AbstractAs marijuana use during adolescence has been increasing, the need to understand the effects of its long-term use becomes crucial. Previous research suggested that marijuana consumption during adolescence increases the risk of developing mental illness, such as schizophrenia, depression, and anxiety. Ghrelin is a peptide produced primarily in the gut and is important for feeding behavior. Recent studies have shown that ghrelin and its receptor, the growth hormone secretagogue receptor (GHSR) play important roles in mediating stress, as well as anxiety and, depression-like behaviors in animal models. Here, we investigated the effects of chronic Tetrahydrocannabinol (THC) administration during adolescence (P42-55), in GHSR (GHSR-/-) knockout mice and their wild type littermates in relation to anxiety-like behaviors. We found that continuous THC exposure during peri-adolescence did not lead to any significant alterations in anxiety-like behavior of male adult mice, regardless of genotype. These data indicate that in the presence of intact GHSR signaling, THC exposure during peri-adolescence has limited if any long term impact on anxiety-like behaviors in mice.


2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 160-160
Author(s):  
Areej El-Jawahri ◽  
Lara Traeger ◽  
Justin Eusebio ◽  
Kailyn Kuzmuk ◽  
Harry Vandusen ◽  
...  

160 Background: While the long-term outcomes of HCT survivors have been described, the acute impact of hospitalization for HCT on patients’ and FC QOL and mood has received little attention. Methods: We conducted a longitudinal study of patients (and FC) hospitalized for HCT. At baseline (6 days pre-HCT), day+1, and day+8 of HCT, we assessed QOL (Functional Assessment of Cancer Therapy-Bone Marrow Transplantation FACT-BMT), fatigue (FACT-Fatigue), and mood (Hospital Anxiety and Depression Scale HADS). We used the SF-36 to examine FC QOL [physical component scale (PCS), and mental component scale (MCS)]. Using multivariable linear mixed models, we examined predictors of QOL changes during hospitalization. Results: We enrolled 97% of consecutively eligible patients undergoing autologous (n=30), myeloablative (n=30) or reduced intensity (n=30) allogeneic HCT. Patients’ QOL markedly declined and fatigue increased throughout hospitalization (Table). The proportion of patients meeting criteria for depression (HADS-D > 7) more than doubled from baseline to day+8 (15.6% to 37.8%, P < 0.0001) whereas the proportion of patients with anxiety remained stable (22.2%, P = 0.8). Depression (β= -2.24, F=42.2, p < 0.0001) and anxiety (β= -0.63, F=4.4, p = 0.03) at baseline independently predict worse QOL throughout hospitalization. The FC QOL declined during patient’s hospitalization (PCS: 83.1 to 79.6, P= 0.03, MCS: 71.6 to 67.4, P = 0.04). Conclusions: Patients undergoing HCT reported a rapid and steep deterioration in QOL along with substantially worse fatigue and depression during hospitalization. Greater decrements in QOL were predicted by depression and anxiety highlighting the importance of assessing pre-HCT psychiatric morbidity. [Table: see text]


2019 ◽  
Vol 10 (1) ◽  
pp. 237-255 ◽  
Author(s):  
Natasha Randall ◽  
Casey C. Bennett ◽  
Selma Šabanović ◽  
Shinichi Nagata ◽  
Lori Eldridge ◽  
...  

AbstractAs healthcare turns its focus to preventative community-based interventions, there is increasing interest in using in-home technology to support this goal. This study evaluates the design and use of socially assistive robots (SARs) and sensors as in-home therapeutic support for older adults with depression. The seal-like SAR Paro, along with onboard and wearable sensors, was placed in the homes of 10 older adults diagnosed with clinical depression for one month. Design workshops were conducted before and after the in-home implementation with participating older adults and clinical care staff members. Workshops showed older adults and clinicians sawseveral potential uses for robots and sensors to support in-home depression care. Long-term in-home use of the robot allowed researchers and participants to situate desired robot features in specific practices and experiences of daily life, and some user requests for functionality changed due to extended use. Sensor data showed that participants’ attitudes toward and intention to use the robot were strongly correlated with particular Circadian patterns (afternoon and evening) of robot use. Sensor data also showed that those without pets interacted with Paro significantly more than those with pets, and survey data showed they had more positive attitudes toward the SAR. Companionship, while a desired capability, emerged as insufficient to engage many older adults in long-term use of SARs in their home.


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