Data-Driven Learning in High-Resolution Activity Sampling From Patients With Bipolar Depression: Mixed-Methods Study.

Darius Adam Rohani*, Nanna Tuxen, Andrea Quemada Lopategui, Lars Vedel Kessing, Jakob Eyvind Bardram

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Background: Behavioral activation is a pen and paper-based therapy form for treating depression. The patient registers their activity hourly, and together with the therapist, they agree on a plan to change behavior. However, with the limited clinical personnel, and a growing patient population, new methods are needed to advance behavioral activation.

Objective: The objectives of this paper were to (1) automatically identify behavioral patterns through statistical analysis of the paper-based activity diaries, and (2) determine whether it is feasible to move the behavioral activation therapy format to a digital solution.

Methods: We collected activity diaries from seven patients with bipolar depression, covering in total 2,480 hours of self-reported activities. A pleasure score, on a 1-10 rating scale, was reported for each activity. The activities were digitalized into 6 activity categories, and statistical analyses were conducted.

Results: Across all patients, movement-related activities were associated with the highest pleasure score followed by social activities. On an individual level, through a nonparametric Wilcoxon Signed-Rank test, one patient had a statistically significant larger amount of spare time activities when feeling bad (z=–2.045, P=.041). Through a within-subject analysis of covariance, the patients were found to have a better day than the previous, if that previous day followed their diurnal rhythm (ρ=.265, P=.029). Furthermore, a second-order trend indicated that two hours of daily social activity was optimal for the patients (β2=–0.08, t (63)=–1.22, P=.23).

Conclusions: The data-driven statistical approach was able to find patterns within the behavioral traits that could assist the therapist in as well as help design future technologies for behavioral activation.
Original languageEnglish
Article numbere10122
JournalJ M I R Mental Health
Issue number2
Number of pages12
Publication statusPublished - 2018


  • Activities
  • Behavior
  • Behavioral activation
  • Bipolar disorder
  • Circadian rhythm
  • Depression
  • Hourly planning
  • Psychotherapy
  • Statistics


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