Abstract
Personal Health Systems: The OPTIMI Project
In the last issues, we discussed the role of personal health systems in offering therapists significant new abilities to monitor patients' conditions, thereby enabling them to diagnose problems earlier and treat them more effectively. The EU is supporting research in this area under the Seventh Framework Programme (FP7—
Coordinator: Dr. Catalina Jimenez Everis Spain SL
The problem
Depression and stress-related disorders are the most common mental illnesses, and the prevention of depression and suicide is one of the five central focus points in the European Pact for Mental Health and Well Being. Currently, the main treatments for mental illness are pharmacological and evidence-based Cognitive Behavioral Therapy (CBT). However, little is being done to develop effective systems for prevention of the onset of the illnesses.
Goals of the project
OPTIMI (Online Predictive Tools for Intervention in Mental Illness) is based on the hypothesis that the central issue and starting point of longer-term mental illness depends on the individual's capacity and ability to cope with stress. Many of us are lucky not to be subject to daily stressful conditions that ultimately will result in changes to our biology and personality. Some are fortunate be able to cope with enormous real pressure. Many, however, are in high-risk situations where, despite their best efforts, they decompensate and develop a depressive disorder.
With the aim of detecting the onset of a mental illness, OPTIMI will:
identify the occurrence of high stress in the individual on a daily basis; determine the ongoing effect of stress on the individual by studying the behaviour pattern over a longer period; make estimates of the baseline changes in the person's state of mind using measurements that closely link depression with cognitive, motor, and verbal behavior.
The technology
OPTIMI will use wearable appliances based on EEG, EGG, cortisol levels, voice analysis, physical activity analysis, and a self reporting electronic diary in order to identify stress-coping behavior patterns.
The smart identification sensors that capture stress, specific behaviors, and test results will be enhanced with a knowledge-based rule system to interpret the data and provide a diagnostic tool for both pharmacological and CBT-based preventative and intervening treatments. OPTIMI will augment two existing computerized CBT systems to use these tools in real time to optimize the treatment cycle.
Expected outcomes
OPTIMI will conduct two phases of trials with volunteers in high-risk situations. The first phase, being held in three countries (China, Switzerland, and Spain) over six months, will use the tools and develop and fine-tune the algorithms against the gold standard of regular therapist interviews. The second phase in two countries (the UK and Spain) will use the calibrated tools and a computerized CBT preventative treatment system to evaluate effectiveness in reducing the impact of stress to high-risk people, as well as the relapse after treatment for depression.