Aesthetic chills mitigate maladaptive cognition in depression.

BACKGROUND: Depression is a major global health challenge, affecting over 300 million people worldwide. Current pharmacological and psychotherapeutic interventions have limited efficacy, underscoring the need for novel approaches. Emerging evidence suggests that peak emotional experiences characterized by awe, transcendence, and meaning hold promise for rapidly shifting maladaptive cognitive patterns in depression. Aesthetic chills, a peak positive emotion characterized by physical sensations such as shivers and goosebumps, may influence reward-related neural pathways and hold promise for modifying core maladaptive beliefs rooted in early adverse experiences. METHODS: We enrolled 96 patients diagnosed with major depressive disorder. A validated database of multimedia known to elicit chills responses (ChillsDB) was used for stimulus presentation. Participants' emotional responses were assessed using the Emotional Breakthrough Inventory (EBI), while shifts in self-schema were measured via the Young Positive Schema Questionnaire (YSPQ). RESULTS: The study found that chill-inducing stimuli have the potential to positively influence the core schema of individuals with depression, impacting areas of self-related beliefs. The associated phenomenology triggered by chills appears to share similarities with the altered states of consciousness induced by psychedelic substances like psilocybin. CONCLUSIONS: These preliminary results suggest that the biological processes involved in aesthetic chills could be harnessed as a non-pharmacological intervention for depression. However, further investigation is necessary to comprehensively understand the neurophysiological responses to chills and to evaluate the practicality, effectiveness, and safety of utilizing aesthetic chills as a preventive measure in mental health care.

Enhancing Agency in Posttraumatic Stress Disorder Therapies Through Sensorimotor Technologies.

Posttraumatic stress disorder (PTSD) is a significant public health concern, with only a third of patients recovering within a year of treatment. While PTSD often disrupts the sense of body ownership and sense of agency (SA), attention to the SA in trauma has been lacking. This perspective paper explores the loss of the SA in PTSD and its relevance in the development of symptoms. Trauma is viewed as a breakdown of the SA, related to a freeze response, with peritraumatic dissociation increasing the risk of PTSD. Drawing from embodied cognition, we propose an enactive perspective of PTSD, suggesting therapies that restore the SA through direct engagement with the body and environment. We discuss the potential of agency-based therapies and innovative technologies such as gesture sonification, which translates body movements into sounds to enhance the SA. Gesture sonification offers a screen-free, noninvasive approach that could complement existing trauma-focused therapies. We emphasize the need for interdisciplinary collaboration and clinical research to further explore these approaches in preventing and treating PTSD.

Insights into medical students' perceptions of work culture during the COVID-19 pandemic: a mixed method study.

BACKGROUND: The COVID-19 pandemic brought about profound social changes that affected students worldwide. These changes had both psychological and economic consequences, and also led to the adoption of new teaching methods. It can also have an impact on work culture, which is the collective set of values, norms, and practices within a specific profession, shaping how individuals in that field behave, communicate, and identify with their work. The aim of the study was to examine medical students' perception of professional culture during the COVID-19 crisis when they voluntarily participated in the healthcare network established, outside of university placements, for the management of COVID patients. METHODS: A questionnaire study based on the vignette methodology was conducted among third-year medical students. Drawing from three scenarios in which students were variably engaged in crisis management, it included questions about their perceptions of the medical profession, their motivation, and their sense of belonging to the profession. RESULTS: 352 students responded to the survey. The pandemic had both a positive and a negative impact on students' perceptions of the medical profession. Cluster analysis using a k-means algorithm and principal component analysis revealed three clusters of students with different perceptions of the medical profession. The first cluster, which represented the majority of students, corresponded to a relatively positive perception of the profession that was reinforced during the pandemic. In the second cluster, students' perceptions were reinforced still further, and particular importance was attached to field experience. Students in the third cluster had the most negative perceptions, having been shaken the most by the pandemic, and they attached little importance to field experience. CONCLUSIONS: The analysis highlighted the importance of students being able to adapt and draw on a range of resources during the COVID-19 pandemic. This underscores the need for work cultures that support adaptability and coping. Further research is needed to understand its long-term effects on students' perceptions of the medical profession and to identify interventions that could support students in the aftermath of this difficult period.

Criteria for evaluating the effectiveness of psychiatric home care-mobile team: A systematic review of the literature.

AIM: To explore criteria evaluating the effectiveness of psychiatric home care-mobile team practices, that have been developed widely in the last decades. DESIGN: Systematic review of the literature. METHODS: We included 24 studies published between January 2010 and October 2023. DATA SOURCES: CINAHL, APA PsycInfo, Embase, Scopus and PubMed. RESULTS: The evaluation criteria differed according to the studies: impact on hospital stay, symptomatic clinical impact, repercussions on functioning, quality of life, analysis of profitability, safety, therapeutic alliance and finally, cooperation network. CONCLUSION: The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices shows their richness and diversity, and the absence of standardisation. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices supports a qualitative and multidisciplinary approach, with enhanced teamwork. IMPACT: Psychiatric home care-mobile team practice have widely developed in the last years and their effectiveness need to be evaluated. Our main finding is that there is a rich variety of practices and that evaluation criteria are very diverse, thus not standardised. We suggest using a mixed-method approach to capture the subjective experience of patients and caregivers. These findings also highlight the significance of institutional cooperative work and call for a redefinition of team construction. REPORTING METHOD: The authors adhered to PRISMA guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Digital Phenotyping: Data-Driven Psychiatry to Redefine Mental Health.

The term "digital phenotype" refers to the digital footprint left by patient-environment interactions. It has potential for both research and clinical applications but challenges our conception of health care by opposing 2 distinct approaches to medicine: one centered on illness with the aim of classifying and curing disease, and the other centered on patients, their personal distress, and their lived experiences. In the context of mental health and psychiatry, the potential benefits of digital phenotyping include creating new avenues for treatment and enabling patients to take control of their own well-being. However, this comes at the cost of sacrificing the fundamental human element of psychotherapy, which is crucial to addressing patients' distress. In this viewpoint paper, we discuss the advances rendered possible by digital phenotyping and highlight the risk that this technology may pose by partially excluding health care professionals from the diagnosis and therapeutic process, thereby foregoing an essential dimension of care. We conclude by setting out concrete recommendations on how to improve current digital phenotyping technology so that it can be harnessed to redefine mental health by empowering patients without alienating them.

Prevention of Suicidal Relapses in Adolescents With a Smartphone Application: Bayesian Network Analysis of a Preclinical Trial Using In Silico Patient Simulations.

BACKGROUND: Recently, artificial intelligence technologies and machine learning methods have offered attractive prospects to design and manage crisis response processes, especially in suicide crisis management. In other domains, most algorithms are based on big data to help diagnose and suggest rational treatment options in medicine. But data in psychiatry are related to behavior and clinical evaluation. They are more heterogeneous, less objective, and incomplete compared to other fields of medicine. Consequently, the use of psychiatric clinical data may lead to less accurate and sometimes impossible-to-build algorithms and provide inefficient digital tools. In this case, the Bayesian network (BN) might be helpful and accurate when constructed from expert knowledge. Medical Companion is a government-funded smartphone application based on repeated questions posed to the subject and algorithm-matched advice to prevent relapse of suicide attempts within several months. OBJECTIVE: Our paper aims to present our development of a BN algorithm as a medical device in accordance with the American Psychiatric Association digital healthcare guidelines and to provide results from a preclinical phase. METHODS: The experts are psychiatrists working in university hospitals who are experienced and trained in managing suicidal crises. As recommended when building a BN, we divided the process into 2 tasks. Task 1 is structure determination, representing the qualitative part of the BN. The factors were chosen for their known and demonstrated link with suicidal risk in the literature (clinical, behavioral, and psychometrics) and therapeutic accuracy (advice). Task 2 is parameter elicitation, with the conditional probabilities corresponding to the quantitative part. The 4-step simulation (use case) process allowed us to ensure that the advice was adapted to the clinical states of patients and the context. RESULTS: For task 1, in this formative part, we defined clinical questions related to the mental state of the patients, and we proposed specific factors related to the questions. Subsequently, we suggested specific advice related to the patient's state. We obtained a structure for the BN with a graphical representation of causal relations between variables. For task 2, several runs of simulations confirmed the a priori model of experts regarding mental state, refining the precision of our model. Moreover, we noticed that the advice had the same distribution as the previous state and was clinically relevant. After 2 rounds of simulation, the experts found the exact match. CONCLUSIONS: BN is an efficient methodology to build an algorithm for a digital assistant dedicated to suicidal crisis management. Digital psychiatry is an emerging field, but it needs validation and testing before being used with patients. Similar to psychotropics, any medical device requires a phase II (preclinical) trial. With this method, we propose another step to respond to the American Psychiatric Association guidelines. TRIAL REGISTRATION: ClinicalTrials.gov NCT03975881; https://clinicaltrials.gov/ct2/show/NCT03975881.

Formation of Giant Unilamellar Proteo-Liposomes by Osmotic Shock.

Giant unilamellar vesicles (GUVs), composed of a phospholipid bilayer, are often used as a model system for cell membranes. However, the study of proteo-membrane interactions in this system is limited as the incorporation of integral and lipid-anchored proteins into GUVs remains challenging. Here, we present a simple generic method to incorporate proteins into GUVs. The basic principle is to break proteo-liposomes with an osmotic shock. They subsequently reseal into larger vesicles which, if necessary, can endure the same to obtain even larger proteo-GUVs. This process does not require specific lipids or reagents, works under physiological conditions with high concentrations of protein, the proteins remains functional after incorporation. The resulting proteo-GUVs can be micromanipulated. Moreover, our protocol is valid for a wide range of protein substrates. We have successfully reconstituted three structurally different proteins, two trans-membrane proteins (TolC and the neuronal t-SNARE), and one lipid-anchored peripheral protein (GABARAP-Like 1 (GL1)). In each case, we verified that the protein remains active after incorporation and in its correctly folded state. We also measured their mobility by performing diffusion measurements via fluorescence recovery after photobleaching (FRAP) experiments on micromanipulated single GUVs. The diffusion coefficients are in agreement with previous data.

Surfactant bilayers maintain transmembrane protein activity.

In vitro studies of membrane proteins are of interest only if their structure and function are significantly preserved. One approach is to insert them into the lipid bilayers of highly viscous cubic phases rendering the insertion and manipulation of proteins difficult. Less viscous lipid sponge phases are sometimes used, but their relatively narrow domain of existence can be easily disrupted by protein insertion. We present here a sponge phase consisting of nonionic surfactant bilayers. Its extended domain of existence and its low viscosity allow easy insertion and manipulation of membrane proteins. We show for the first time, to our knowledge, that transmembrane proteins, such as bacteriorhodopsin, sarcoplasmic reticulum Ca(2+)ATPase (SERCA1a), and its associated enzymes, are fully active in a surfactant phase.

Characteristics of Pseudomonas aeruginosa infection in intensive care unit before (2007-2010) and after (2011-2014) the beginning of an antimicrobial stewardship program.

Objectives: To investigate the factors associated with Pseudomonas aeruginosa isolates in intensive care unit (ICU) before and after an antimicrobial stewardship program. Materials: Monocentric retrospective cohort study. Patients admitted to the ICU in 2007-2014 were included. Characteristics of P. aeruginosa patients were compared to overall ICU population. Clinical and microbiological characteristics of P. aeruginosa patients before (2007-2010) and after (2011-2014) the beginning of the AMP were compared. Results: Overall, 5,263 patients were admitted to the ICU, 274/5,263 (5%) had a P. aeruginosa isolate during their staying. In 2011-2014, the percentage P. aeruginosa isolates reduced (7% vs 4%, P ≤ .0001). Patients with P. aeruginosa had higher rates of in-hospital death (43% vs 20%, P < .0001) than overall ICU population. In 2011-2014, rates of multidrug-resistant (11% vs 2%, P = .0020), fluoroquinolone-resistant (35% vs 12%, P < .0001), and ceftazidime-resistant (23% vs 8%, P = .0009) P. aeruginosa reduced. Treatments by fluoroquinolones (36% vs 4%, P ≤ .0001), carbapenems (27% vs 9%, P = .0002), and third-generation cephalosporins (49% vs 12%, P ≤ .0001) before P. aeruginosa isolation reduced while piperacillin (0% vs 13%, P < .0001) and trimethoprim-sulfamethoxazole (8% vs 26%, P = .0023) increased. Endotracheal intubation reduced in 2011-2014 (61% vs 35%, P < .0001). Fluoroquinolone-resistance was higher in patients who received endotracheal intubation (29% vs 17%, P = .0197). Previous treatment by fluoroquinolones (OR = 2.94, P = .0020) and study period (2007-2010) (OR = 2.07, P = .0462) were the factors associated with fluoroquinolone-resistance at the multivariate analysis. Conclusions: Antibiotic susceptibility in P. aeruginosa isolates was restored after the reduction of endotracheal intubation, fluoroquinolones, carbapenems, and third-generation cephalosporins and the increased use of molecules with a low ecological footprint, as piperacillin and trimethoprim-sulfamethoxazole.

Kinetic study of membrane protein interactions: from three to two dimensions.

Molecular interactions are contingent upon the system's dimensionality. Notably, comprehending the impact of dimensionality on protein-protein interactions holds paramount importance in foreseeing protein behaviour across diverse scenarios, encompassing both solution and membrane environments. Here, we unravel interactions among membrane proteins across various dimensionalities by quantifying their binding rates through fluorescence recovery experiments. Our findings are presented through the examination of two protein systems: streptavidin-biotin and a protein complex constituting a bacterial efflux pump. We present here an original approach for gauging a two-dimensional binding constant between membrane proteins embedded in two opposite membranes. The quotient of protein binding rates in solution and on the membrane represents a metric denoting the exploration distance of the interacting sites-a novel interpretation.

Interoceptive technologies for psychiatric interventions: From diagnosis to clinical applications.

Interoception-the perception of internal bodily signals-has emerged as an area of interest due to its implications in emotion and the prevalence of dysfunctional interoceptive processes across psychopathological conditions. Despite the importance of interoception in cognitive neuroscience and psychiatry, its experimental manipulation remains technically challenging. This is due to the invasive nature of existing methods, the limitation of self-report and unimodal measures of interoception, and the absence of standardized approaches across disparate fields. This article integrates diverse research efforts from psychology, physiology, psychiatry, and engineering to address this oversight. Following a general introduction to the neurophysiology of interoception as hierarchical predictive processing, we review the existing paradigms for manipulating interoception (e.g., interoceptive modulation), their underlying mechanisms (e.g., interoceptive conditioning), and clinical applications (e.g., interoceptive exposure). We suggest a classification for interoceptive technologies and discuss their potential for diagnosing and treating mental health disorders. Despite promising results, considerable work is still needed to develop standardized, validated measures of interoceptive function across domains and before these technologies can translate safely and effectively to clinical settings.

Higher stress response and altered quality of life in schizophrenia patients with low membrane levels of docosahexaenoic acid.

Schizophrenia is a severe, chronic, and heterogeneous mental disorder that affects approximately 1% of the world population. Ongoing research aims at clustering schizophrenia heterogeneity into various "biotypes" to identify subgroups of individuals displaying homogeneous symptoms, etiopathogenesis, prognosis, and treatment response. The present study is in line with this approach and focuses on a biotype partly characterized by a specific membrane lipid composition. We have examined clinical and biological data of patients with stabilized schizophrenia, including the fatty acid content of their erythrocyte membranes, in particular the omega-3 docosahexaenoic acid (DHA). Two groups of patients of similar size were identified: the DHA- group (N = 19) with a lower proportion of membrane DHA as compared to the norm in the general population, and the DHAn group (N = 18) with a normal proportion of DHA. Compared to DHAn, DHA- patients had a higher number of hospitalizations and a lower quality of life in terms of perceived health and physical health. They also exhibited significant higher interleukin-6 and cortisol blood levels. These results emphasize the importance of measuring membrane lipid and immunoinflammatory biomarkers in stabilized patients to identify a specific subgroup and optimize non-pharmacological interventions. It could also guide future research aimed at proposing specific pharmacological treatments.

Repetitive Transcranial Magnetic Stimulation (rTMS) in Post-Traumatic Stress Disorder: Study Protocol of a Nationwide Randomized Controlled Clinical Trial of Neuro-Enhanced Psychotherapy "TraumaStim".

The use of high-frequency Transcranial Magnetic Stimulation (HF-rTMS) of the right dorsolateral prefrontal cortex (DLPFC) in treating Post-traumatic Stress Disorder (PTSD) is currently regarded as a level B intervention (probable effectiveness). HF-rTMS has attracted interest as a neuromodulation therapeutic method for PTSD. Prolonged exposure and reactivation therapy are also regarded as first-line treatments for PTSD. Randomized controlled clinical studies examining the effectiveness of several HF-rTMS sessions coupled with psychotherapy have not yet been completed. In total, 102 patients with refractory PTSD will be randomly assigned (1:1) to reactivation therapy, in addition to either active HF-rTMS (20 Hz) or sham HF-rTMS, for 12 sessions in a nationwide, multicenter, double-blind controlled trial. The impact on PTSD symptoms and neurocognitive functioning will be assessed. The primary outcome is the PTSD severity score measured based on the Clinician-Administered PTSD Scale (CAPS-5) at one month. If this additional therapy is successful, it may strengthen the case for regulatory authorities to approve this additional technique of treating PTSD. Additionally, it expands the field of neurostimulation-assisted psychotherapy.

Attachment and Mental Health of Men Having Sex with Men Engaging in Chemsex: Is Substance Abuse Only the Tip of the Iceberg?

Gay and bisexual men and other men who have sex with men (GBMSM) with problematic chemsex (a specific sexualized drug use pattern) face several health issues. The aim of this monocentric observational study was to assess the mental health history and attachment style (AS) within 71 GBMSM seeking care for problematic chemsex. Attachment style (AS) was evaluated using the Relationship Scales Questionnaire. 82% of the cohort (58) had at least one mental health disorder (among depression, anxiety, alcohol use disorder or hypersexuality). 9.9% were admitted to intensive care due to chemsex use. Traumas were frequent, with 31% reporting childhood sex abuse and 24% declaring having attempted suicide. 62 (87%) had insecure AS: 38% preoccupied, 23% fearful and 24% dismissing. Users with a positive self model (N = 24) had fewer comorbidities (63% vs 92%, p = .003) and practiced more chemsex alone (75% vs 33%, p < .001) than users with negative self model (N = 47). Users with a positive other model (N = 35) practiced more slamsex (injections of substance in a sexual context) (80% vs 50%, p = .008) and had fewer comorbidities (71% vs 92%, p = .027) than users with a negative other model (N = 36). Attachment theory is a way to provide holistic and tailored and harm reduction.

Association between family functioning and psychotic transition in ultra-high risk adolescents and young adults.

Background: Psychotic transition (PT) is a crucial stage in schizophrenia. The Comprehensive Assessment of At-Risk Mental States (CAARMS) scale can be used to identify individuals at ultra-high risk (UHR) for psychosis and to evaluate their risk of PT. Many environmental and genetic factors have been identified as contributing to the development and decompensation of schizophrenia. This study aimed to determine if the quality of family functioning is associated with PT risk in UHR individuals aged between 11 and 25 years after 1 year of follow-up. Methods: From January to November 2017, 45 patients aged 12 to 25 consulting for psychiatric reasons were included. Twenty-six were classified as UHR of PT at the CAARMS. Family functioning was assessed by the Family Assessment Device-Global Functioning (FAD-GF). Thirty-seven of these patients (30% men, mean age 16 ± 2.5) were reassessed at 8-14 months of recruitment. Survival analysis was used to examine the impact of family functioning on PT risk. Results: A total of 40% of UHR patients were classified as psychotic at reassessment. Survival analysis showed that better family functioning is a significant protective factor for PT in this population. Discussion: This result suggests that the global family functioning has an impact at 1 year on the risk of PT in the population of adolescents and young adults who consult the hospital for psychiatric reasons. A family intervention may be effective in reducing PT risk in this population and should be considered as a potential therapeutic option.

Rapid cycling bipolar disorder: Literature review on pharmacological treatment illustrated by a case report on ketamine.

INTRODUCTION: Rapid cycling bipolar disorder (RCBD) is defined as four or more affective episodes (depression, mania or hypomania) within 1 year. RCBD has a high point of prevalence (from 10% to 20% among clinical bipolar samples) and is associated with greater severity, longer illness duration, worse global functioning and higher suicidal risk, but there is no consensus on treatment option. The use of several pharmacological agents has been reported (levothyroxine, antipsychotics, antidepressants and mood stabilizers). OBJECTIVE: The main objective of this review was to propose a critical review of the literature and to rank the pharmacological agent using a level of evidence (LEO) adapted from the Center for Evidence-Based Medicine, and to illustrate it with a case report on off-label intravenous ketamine. METHOD: We conducted a review using the MeSH terms and keywords (bipolar [Title/Abstract]) AND (rapid [Title/Abstract]) AND (cycling [Title/Abstract]) AND (treatment [Title/Abstract]). Alexis Bourla and Stéphane Mouchabac screened 638 documents identified through literature search in Medline (PubMed) or by bibliographic references and 164 abstracts were then analyzed. Nonpharmacological treatments were excluded. RESULT: Seventy articles were included in the review and divided into six categories: mood stabilizers, antipsychotics, hormonal treatments, ketamine and other pharmacological treatments. DISCUSSION: Our review highlights the heterogeneity of the pharmacological treatment of RCBD and no clear consensus can emerge.

How to best estimate the viscosity of lipid bilayers.

The viscosity of lipid bilayers is a property relevant to biological function, as it affects the diffusion of membrane macromolecules. To determine its value, and hence portray the membrane, various literature-reported techniques lead to significantly different results. Herein we compare the results issuing from two widely used techniques to determine the viscosity of membranes: the Fluorescence Lifetime Imaging Microscopy (FLIM), and Fluorescence Recovery After Photobleaching (FRAP). FLIM relates the time of rotation of a molecular rotor inserted into the membrane to the macroscopic viscosity of a fluid. Whereas FRAP measures molecular diffusion coefficients. This approach is based on a hydrodynamic model connecting the mobility of a membrane inclusion to the viscosity of the membrane. We show that: This article emphasizes the pitfalls to be avoided and the rules to be observed in order to obtain a value of the bilayer viscosity that characterizes the bilayer instead of interactions between the bilayer and the embedded probe.

Functional neuro-anatomy of social cognition in posttraumatic stress disorder: A systematic review.

OBJECTIVE: Post-traumatic stress disorder (PTSD) is a common mental disorder following one or more traumatic events in which patients exhibit behavioural and emotional disturbances. Recent studies report alterations in social cognition with cerebral functioning modifications. While it is now established that brain function can be modified and severely altered following successive childhood traumas, less studies have focused on brain alterations in adults with normal social cognition development. METHODS: We conducted a selective literature review by querying PubMed and Embase databases for titles of articles research on PTSD adults published from January 2000 to December 2021 focusing on adulthood traumatic events. RESULTS: Majority of studies reported frontolimbic rupture, with limbic structures like amygdala missing top-down control of frontal regulation. These cerebral dysfunctions could be observed even without overt behavioural defects on social cognition tests. CONCLUSION: These results can be analysed in light of intrinsic cerebral networks and we propose an attentional model of social threat information processing opening up perspective of social attentional rehabilitation in adjunction to usual care.

Digital phenotype of mood disorders: A conceptual and critical review.

Background: Mood disorders are commonly diagnosed and staged using clinical features that rely merely on subjective data. The concept of digital phenotyping is based on the idea that collecting real-time markers of human behavior allows us to determine the digital signature of a pathology. This strategy assumes that behaviors are quantifiable from data extracted and analyzed through digital sensors, wearable devices, or smartphones. That concept could bring a shift in the diagnosis of mood disorders, introducing for the first time additional examinations on psychiatric routine care. Objective: The main objective of this review was to propose a conceptual and critical review of the literature regarding the theoretical and technical principles of the digital phenotypes applied to mood disorders. Methods: We conducted a review of the literature by updating a previous article and querying the PubMed database between February 2017 and November 2021 on titles with relevant keywords regarding digital phenotyping, mood disorders and artificial intelligence. Results: Out of 884 articles included for evaluation, 45 articles were taken into account and classified by data source (multimodal, actigraphy, ECG, smartphone use, voice analysis, or body temperature). For depressive episodes, the main finding is a decrease in terms of functional and biological parameters [decrease in activities and walking, decrease in the number of calls and SMS messages, decrease in temperature and heart rate variability (HRV)], while the manic phase produces the reverse phenomenon (increase in activities, number of calls and HRV). Conclusion: The various studies presented support the potential interest in digital phenotyping to computerize the clinical characteristics of mood disorders.