Lundbeck Institute Magazine Issue 20

About this issue

There are few things all doctors will agree on, but I suspect that all would concur with the claims made in the following three articles: The rise of the age of information and social media will have a huge impact on healthcare. On the downside, there is the 24/7 access to problematic behaviours, such as online gambling and pornography, that will lead to more compulsive behaviours and dependence problems.

On the upside, we already have access to online programmes to help treat anxiety and depression through cognitive and behavioural approaches. But there is much more to come. As the three articles explain, the data gathered from use of the internet and social media could alter both the collection of data on mental illnesses as well as potentially drive improvements in education and treatment of these disorders.

At the most straightforward level, easy access to information on when and how someone’s mood or thinking processes are changing could facilitate early access to treatment services. At a more advanced level, searching for terms such as “voices” or “feeling paranoid”, which can be detected by search algorithms, will make it possible – with appropriate controls in place – to more quickly identify people with incipient depression or schizophrenia. They could also be monitored more effectively through the internet and through activities such as their texting rates and content. Wearable devices such as heart rate and sleep monitors linked to mobile phones could be used to measure the adverse effectsmof medication and direct activity programmes to minimise these.

The power of repeated sampling via the ecological momentary assessment (EMA) approach could also be used as a more finegrained analysis to evaluate the effects of new treatments. Sampling moods four or more times a day is possible using PDA-based questions, which is much more than one could ever do with the traditional out-patient clinical trial assessments. In theory, feedback from these reports could also be used to help people work to improve behaviours that could lift mood, though there is always the possibility that negative outcomes could emerge. For example, a depressed person might become more despondent if they are repeatedly told on their phone that their mood seems to be dropping. Of course, similar issues will be present in relation to schizophrenia where the idea of being monitored might accentuate paranoia.

Beyond this, we get into the more science fiction area of using electronic communications to develop new treatment approaches. Cross-linking social media activity could be used to explore the effects of season, temperature, viral infections and more on population mood and behaviour. These could help inform public health interventions.

In the end, the vast data that can be collected using electronic technology will become merged with other “large data” sets, such as genetic variants and health and education records. Such interactions could potentially lead to a whole new approach to diagnostic and epidemiological medicine. The three following articles give a clear and concise perspective on current possibilities and future potential of these rapidly evolving technologies

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