Digital phenotyping correlates of mobile cognitive measures in schizophrenia: A multisite global mental health feasibility trial.

Traditional cognitive assessments in schizophrenia are time-consuming and necessitate specialized training, making routine evaluation challenging. To overcome these limitations, this study investigates the feasibility and advantages of utilizing smartphone-based assessments to capture both cognitive functioning and digital phenotyping data and compare these results to gold standard measures. We conducted a secondary analysis of data from 76 individuals with schizophrenia, who were recruited across three sites (one in Boston, two in India) was conducted. The open-source mindLAMP smartphone app captured digital phenotyping data and Trails A/B assessments of attention / memory for up to 12 months. The smartphone-cognitive tasks exhibited potential for normal distribution and these scores showed small but significant correlations with the results from the Brief Assessment of Cognition in Schizophrenia, especially the digital span and symbol coding tasks (r2 = 0.21). A small but significant correlation (r2 = 0.29) between smartphone-derived cognitive scores and health-related behaviors such as sleep duration patterns was observed. Smartphone-based cognitive assessments show promise as cross-cultural tools that can capture relevant data on momentary states among individuals with schizophrenia. Cognitive results related to sleep suggest functional applications to digital phenotyping data, and the potential of this multimodal data approach in research.

Relapse prediction in schizophrenia with smartphone digital phenotyping during COVID-19: a prospective, three-site, two-country, longitudinal study.

Smartphone technology provides us with a more convenient and less intrusive method of detecting changes in behavior and symptoms that typically precede schizophrenia relapse. To take advantage of the aforementioned, this study examines the feasibility of predicting schizophrenia relapse by identifying statistically significant anomalies in patient data gathered through mindLAMP, an open-source smartphone app. Participants, recruited in Boston, MA in the United States, and Bangalore and Bhopal in India, were invited to use mindLAMP for up to a year. The passive data (geolocation, accelerometer, and screen state), active data (surveys), and data quality metrics collected by the app were then retroactively fed into a relapse prediction model that utilizes anomaly detection. Overall, anomalies were 2.12 times more frequent in the month preceding a relapse and 2.78 times more frequent in the month preceding and following a relapse compared to intervals without relapses. The anomaly detection model incorporating passive data proved a better predictor of relapse than a naive model utilizing only survey data. These results demonstrate that relapse prediction models utilizing patient data gathered by a smartphone app can warn the clinician and patient of a potential schizophrenia relapse.

Smartphone digital phenotyping, surveys, and cognitive assessments for global mental health: Initial data and clinical correlations from an international first episode psychosis study.

Objective: To examine feasibility and acceptability of smartphone mental health app use for symptom, cognitive, and digital phenotyping monitoring among people with schizophrenia in India and the United States. Methods: Participants in Boston, USA and Bhopal and Bangalore, India used a smartphone app to monitor symptoms, play cognitive games, access relaxation and psychoeducation resources and for one month, with an initial clinical and cognitive assessment and a one-month follow-up clinical assessment. Engagement with the app was compared between study sites, by clinical symptom severity and by cognitive functioning. Digital phenotyping data collection was also compared between three sites. Results: By Kruskal-Wallis rank-sum test, we found no difference between app activities completed or digital phenotyping data collected across the three study sites. App use also did not correlate to clinical or cognitive assessment scores. When using the app for symptom monitoring, preliminary findings suggest app-based assessment correlate with standard cognitive and clinical assessments. Conclusions: Smartphone app for symptom monitoring and digital phenotyping for individuals with schizophrenia appears feasible and acceptable in a global context. Clinical utility of this app for real-time assessments is promising, but further research is necessary to determine the long-term efficacy and generalizability for serious mental illness.

Cross cultural and global uses of a digital mental health app: results of focus groups with clinicians, patients and family members in India and the United States.

BACKGROUND: Despite significant advancements in healthcare technology, digital health solutions - especially those for serious mental illnesses - continue to fall short of their potential across both clinical practice and efficacy. The utility and impact of medicine, including digital medicine, hinges on relationships, trust, and engagement, particularly in the field of mental health. This paper details results from Phase 1 of a two-part study that seeks to engage people with schizophrenia, their family members, and clinicians in co-designing a digital mental health platform for use across different cultures and contexts in the United States and India. METHODS: Each site interviewed a mix of clinicians, patients, and their family members in focus groups (n = 20) of two to six participants. Open-ended questions and discussions inquired about their own smartphone use and, after a demonstration of the mindLAMP platform, specific feedback on the app's utility, design, and functionality. RESULTS: Our results based on thematic analysis indicate three common themes: increased use and interest in technology during coronavirus disease 2019 (COVID-19), concerns over how data are used and shared, and a desire for concurrent human interaction to support app engagement. CONCLUSION: People with schizophrenia, their family members, and clinicians are open to integrating technology into treatment to better understand their condition and help inform treatment. However, app engagement is dependent on technology that is complementary - not substitutive - of therapeutic care from a clinician.

Identification of Patterns of Cognitive Impairment for Early Detection of Dementia.

Early detection of dementia is crucial to devise effective interventions. Comprehensive cognitive tests, while being the most accurate means of diagnosis, are long and tedious, thus limiting their applicability to a large population, especially when periodic assessments are needed. The problem is compounded by the fact that people have differing patterns of cognitive impairment as they progress to different forms of dementia. This paper presents a novel scheme by which individual-specific patterns of impairment can be identified and used to devise personalized tests for periodic follow-up. Patterns of cognitive impairment are initially learned from a population cluster of combined normals and cognitively impaired subjects, using a set of standardized cognitive tests. Impairment patterns in the population are identified using a 2-step procedure involving an ensemble wrapper feature selection followed by cluster identification and analysis. These patterns have been shown to correspond to clinically accepted variants of Mild Cognitive Impairment (MCI), a prodrome of dementia. The learned clusters of patterns can subsequently be used to identify the most likely route of cognitive impairment, even for pre-symptomatic and apparently normal people. Baseline data of 24,000 subjects from the NACC database was used for the study.

Marital Quality in Middle Aged Women: A Qualitative study

Background: Marital quality is an essential feature of family life that affects one’s wellbeing; higher marital quality is linked to less vulnerability to depression, self-rated health, less physical ailments and subjective well-being and happiness. Cross sectional studies have found low marital satisfaction and happiness in middle aged adults compared to the younger or older adults, whereas cohort studies have revealed that marital quality tends to decrease after the initial of marriage years and into the middle adulthood and then either steadies or continue to decrease after midlife. This study explored marital quality in women and the dimensions that contribute to greater marital quality in midlife stage of marriage. Methodology: The sample consisted of 15 middle aged married women. A semi-structured interview schedule was used to explore their marital quality and the dimensions related to marital quality. The interviews were analysed using content analysis method. Results: The results showed that aspects such as handling problems and disagreements, communication, having an egalitarian approach, making compromises or adjustments, support of extended family were related to better marital quality. Conclusion: The study highlights that marital enrichment programs that focus on communication between partners, problem solving strategies and effective handling of disagreements can increase the marital quality and strengthen the marital relationship.

Dhat Syndrome: a socio-cultural perspective

Dhat syndrome is a culture bound syndrome originating in the Indian sub-continent. Various cultures or religions have discussed about ill effects of semen loss and anxiety related to semen loss is one of the core symptoms of Dhat syndrome. It is found to be most prevalent among young men coming from rural background with poor education. Further, Dhat syndrome has been associated with comorbid depression, anxiety and substance abuse. Management of Dhat syndrome includes combination of psychoeducation, sex education, medications and psychotherapy. This paper intends to provide and the place the origins of Dhat syndrome in culture context and discusses the socio-cultural factors that tends maintain it.

Superstitious Behaviour in Sportspersons in Relation to Their Performance at Intercollegiate Level

Background: Superstitions are beliefs that fate is governed by uncontrollable external forces. Superstitionsplay a key role in sports since they associate with activities involving danger and lack of predictability. Therehas been a dearth of studies regarding the effect such superstitious beliefs have on athletes’ performance, andon the looking superstitions from a qualitative perspective, specifically on Indian population, hence thisstudy aims to explore the various superstitious beliefs (SB) endorsed by team sportspersons at intercollegiatelevel and analyze how these beliefs affect their sports performance. This study also aimed at analysing thegender differences within different team sports.Methods: Data was collected using purposive and snowball sampling technique. 50 sportspersons frombadminton, basketball, football, cricket, hockey, and volleyball participated. Semi- structured interviewswere conducted to obtain rich data. Content analysis was carried out to obtain the emerging themes.Results: The major themes which emerged from the data include nature, origin, frequency, impact,intentionality, evolution, and orientation of superstitions in reality.Conclusion: Further research is needed in the Indian context regarding sensitivity towards superstitious andthe need to incorporate them in coaching for enhancing performance

Exploring the Effective Counselling Practices being followed in India by Mental Health Professionals

Background: Use of counselling as a therapeutic tool for the betterment of people in distress has grownrapidly over the years. As Mental Health professionals, dealing with humans and related psychological risks,it is one of the most responsible jobs. The current study is an attempt towards examining the effectivecounselling practices that are being followed in India and to gain an insight into the knowledge and trainingof Mental Health Counsellors.Methods: The research was carried out on 14 counsellors working in Mumbai and Bangalore of minimumeducation qualification being a master's degree in counselling psychology. In this qualitative study, Sociodemographic data sheet, semi-structured interview schedule, and worksheet were used. The data gatheredwas analyzed by directed content analysis.Results: Certain dimensions of counselling were in line with past literature, however, the need of licensureexam for counsellors, government body regulating policies and mental health laws, better coursework andpractical training programs, difficulty in following complete ethical practices, emphasis on personal therapyand supervision emerged.Conclusion: The current study provides rich data in terms of how effective the counselling practices arebeing followed in India and highlights the pitfalls and gaps which needs to be resolved.