Longitudinal Digital Mood Charting in Bipolar Disorder: Experiences with ChronoRecord Over 20 Years

Introduction Longitudinal study is an essential methodology for understanding disease trajectories, treatment effects, symptom changes, and long-term outcomes of affective disorders. Daily self-charting of mood and other illness-related variables is a commonly recommended intervention. With the widespread acceptance of home computers in the early 2000s, automated tools were developed for patient mood charting, such as ChronoRecord, a software validated by patients with bipolar disorder. The purpose of this study was to summarize the daily mood, sleep, and medication data collected with ChronoRecord, and highlight some of the key research findings. Lessons learned from implementing a computerized tool for patient self-reporting are also discussed. Methods After a brief training session, ChronoRecord software for daily mood charting was installed on a home computer and used by 609 patients with affective disorders. Results The mean age of the patients was 40.3 +/- 11.8 years, a mean age of onset was 22 +/- 11.2 years, and 71.4 % were female. Patients were euthymic for 70.8 % of days, 15.1 % had mild depression, 6.6 % had severe depression, 6.6 % had hypomania, and 0.8 % had mania. Among all mood groups, 22.4 % took 1-2 medications, 37.2 % took 3-4 medications, 25.7 took 5-6 medications, 11.6 % took 7- 8 medications, and 3.1 % took > 8 medications. Conclusion The daily mood charting tool is a useful tool for increasing patient involvement in their care, providing detailed patient data to the physician, and increasing understanding of the course of illness. Longitudinal data from patient mood charting was helpful in both clinical and research settings.