Handheld devices help doctors track patient moods

August 14, 2014

In a new study underway at Sunnybrook, patients with mood disorders are filling out electronic mood journals on their handheld devices, providing important information about mood changes directly to their doctor’s office.

“In one picture, the psychiatrist at the receiving end gets a snapshot of how things are going,” says Dr. David Kreindler, principal investigator of the trial and head of the Division of Youth Psychiatry at Sunnybrook. “Not many people carry around a pen and paper, so this updated version of a traditional mood journal is one of the most powerful ways to help clarify diagnosis, environmental factors, and track if a patient’s treatment is working.”

Each day, research participants respond to a prompt and fill out a questionnaire on their device in less than a minute. The questionnaire tracks important indicators – like mood, sleep and appetite – of how they are feeling and whether their medication may be working, for example.

With just a few clicks and drags, patients can input information that is sent back to the patient’s doctor in real time. Colourful mood charts are created automatically and are available for the clinician to access when the patient shows up in the office for an appointment. The graphs show ratings of depression, sadness, or happiness for example, with accompanying annotated notes from the patient. The doctor can also add notes commenting on what was going on at the time, and ask the patient for more detail.

“If I asked you to describe the weather over the past month, that would be very hard to do. But when you use a graph or picture, it becomes easy. We think the same principle will apply to someone’s mood,” says Dr. Anthony Levitt, a co-investigator of the study. “For example, if we can see a patient’s mood improved or declined at the same time they started a certain medication, that will help us provide the best possible course of treatment. It’s helpful to be able to go back and see what made a difference and when, because people usually can’t recall those details. It’s much more effective to understand what’s happened to someone’s mood in pictures. You can see where it’s gone up, when it’s gone down, when it’s fluctuating.”

The questionnaires can be geared to individual needs; for example, some look for depression or mania, and others are more generalized and may track status such as whether the patient has been to a hospital.

“Our hope is this will equate to more accurate and improved clinical decision making and better patient outcomes by providing us with better quality and quantity of information to draw from,” adds Dr. Kreindler. “We are testing whether this will reduce rates of illness recurrence.”

The study, called Physician Access to Telemetry from Handheld – Mood Disorders (PATH-MOD), will continue over the next few months. For more information on eligibility, contact Felicia Zhang at 416.528-0396.

Full media release

Patients using handheld devices to help doctors track and treat mood

August 14, 2014 (Toronto, ON) – In a new study underway at Sunnybrook, patients with mood disorders are filling out electronic mood journals on their handheld devices, providing important information about mood changes directly to their doctor’s office.

“In one picture, the psychiatrist at the receiving end gets a snapshot of how things are going,” says Dr. David Kreindler, principal investigator of the trial and head of the Division of Youth Psychiatry at Sunnybrook Health Sciences Centre. “Not many people carry around a pen and paper, so this updated version of a traditional mood journal is one of the most powerful ways to help clarify diagnosis, environmental factors, and track if a patient’s treatment is working.”

Each day, research participants respond to a prompt and fill out a questionnaire on their device in less than a minute. The questionnaire tracks important indicators – like mood, sleep and appetite – of how they are feeling and whether their medication may be working, for example.

With just a few clicks and drags, patients can input information that is sent back to the patient’s doctor in real time. Colourful mood charts are created automatically and are available for the clinician to access when the patient shows up in the office for an appointment. The graphs show ratings of depression, sadness, or happiness for example, with accompanying annotated notes from the patient. The doctor can also add notes commenting on what was going on at the time, and ask the patient for more detail.

“If I asked you to describe the weather over the past month, that would be very hard to do. But when you use a graph or picture, it becomes easy. We think the same principle will apply to someone’s mood,” says Dr. Anthony Levitt, a co-investigator of the study who also has some of his patients participating in the study. “For example, if we can see a patient’s mood improved or declined at the same time they started a certain medication, that will help us provide the best possible course of treatment. It’s helpful to be able to go back and see what made a difference and when, because people usually can’t recall those details. It’s much more effective to understand what’s happened to someone’s mood in pictures. You can see where it’s gone up, when it’s gone down, when it’s fluctuating.”

The questionnaires can be geared to individual needs; for example, some look for depression or mania, and others are more generalized and may track status such as whether the patient has been to a hospital.

“Our hope is this will equate to more accurate and improved clinical decision making and better patient outcomes by providing us with better quality and quantity of information to draw from,” adds Dr. Kreindler, also an assistant professor in the Department of Psychiatry at University of Toronto. “We are testing whether this will reduce rates of illness recurrence.”

Past tests of the software have found that reporting rates are approximately 75 percent, considered very high. “Having the questionnaires at a patient’s fingertips is key,” adds Kreindler. “With electronic mood journals, more people complete them daily and tend to prefer them over paper and pen journals.”

The data is secured with the appropriate privacy and security measures in place and stored on one of the hospital’s servers. The software is platform independent so almost any smart phone can be used in the study.


The Department of Psychiatry and the Centre for Mobile Computing in Mental Health at Sunnybrook has been researching the use of telemetry for 14 years; more recently in the past few years testing its use clinically with patients. This study was funded by the Sunnybrook AFP Innovations Fund.

The study, called Physician Access to Telemetry from Handheld – Mood Disorders (PATH-MOD), will continue over the next few months. To be eligible, one must be 14 years of age and older with a diagnosed mood disorder, need a treating clinician at Sunnybrook who is following their mental health, and has a cell phone with data capability. For more information, contact Felicia Zhang at 416.528-0396.

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Media Contact:

Nadia Norcia Radovini

Communications & Stakeholder Relations

Sunnybrook Health Sciences Centre

416.480.4040

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