Vincent van Gogh, who was diagnosed after his death, was probably one of the most famous people who suffered from bipolar disorder. His birthday on March 30 now marks the bipolar awareness day, which was established to raise awareness and eliminate prejudices about the disease by the Asian Network of Bipolar Disorder (ANBD), the International Bipolar Foundation (IBPF) and the International Society for Bipolar Disorder (ISBD).
Although the disease is known for alternating mood changes including depressive, (hypo-)manic and psychotic symptoms which must be present for diagnosis, the disorder shows various heterogeneous phenotypic expressions regarding symptomatology and intensity of the symptoms (Charney, Mullins, Park & Xu, 2020). Bipolar disorder is broadly divided into three types: Bipolar I is characterized by the recurrent depressive and manic phases, while Bipolar type II consists of depressive and hypomanic phases. This means that the manic phase has a lower intensity than in Type I of the bipolar disorder. The third type – Cyclothymia – is a tendency towards alternating high and low mood states that do not reach the intensity of bipolar I or II (Johnson et al., 2012). Moreover, people can also experience the so-called “other specified and unspecified bipolar and related disorders” including the schizoaffective disorder bipolar type – which do not specifically match the symptoms of the three types above (cf. NIH).
Besides the prominent Vincent van Gogh, a large and growing number of people suffer from bipolar disorder. The 2017 Global Health Metrics study, a study which includes a comprehensive evaluation of incidence and prevalence in 195 countries from 1990 to 2017, shows that nearly 46 million people have been diagnosed with a bipolar disorder in the year 2017. In comparison to 2007, there was an overall increase of 15%.
Currently, the diagnosis is mainly assigned via the Diagnostic And Statistical Manual Of Mental Disorders (DSM), which is based on patient information and clinical evaluation, but not objective testing (Faurholt-Jepsen et al., 2019).Thus, in recent searches for objective markers for diagnosis or to predict mood change, technical systems are increasingly being considered. For example, the value of mobile tools to automatically track treatment and progression of Bipolar Disorder (cf. Dunster, Swendsen & Merikangas, 2021) has been demonstrated. Using a smartphone to track the mood symptoms on a daily basis has been greatly facilitated by the availability of mobile devices (K.D. Denicoff et al., 2002).
New technologies have the power to complement traditional clinical retrospective assessments. Most importantly, real-time behavioral information is leading to insights into manifestations and interrelationships among mental health domains to improve treatments and fill gaps in existing mental health care (cf. Dunster, Swendsen & Merikangas, 2021). However, research in this area is still at an early stage, and based on a review by Faurholt-Jepsen, Bauer & Lessing (2018), too few randomized control trials with sufficient sample size that include patients with more severe symptoms remain to establish this approach.