Smartphone-Centred Wearable Sensors Network for Monitoring Patients with Bipolar Disorder Alessandro Puiatti, Steven Mudda, Silvia Giordano and Oscar Mayora Abstract— Bipolar Disorder is a severe form of mental illness. It is characterized by alternated episodes of mania and depression, and it is treated typically with a combination of pharmacotherapy and psychotherapy. Recognizing early warning signs of upcoming phases of mania or depression would be of great help for a personalized medical treatment. Unfortunately, this is a difficult task to be performed for both patient and doctors. In this paper we present the MONARCA wearable system, which is meant for recognizing early warning signs and predict maniac or depressive episodes. The system is a smartphone-centred and minimally invasive wearable sensors network that is being developing in the framework of the MONARCA European project. I. I NTRODUCTION B IPOLAR Disorder, formerly known as manic depres- sion, is a common and severe form of mental illness [1]. It is characterized by alternated episodes of mania and depression, and, typically, its treatment is based on a combination of pharmacotherapy and psychotherapy. Unfor- tunately, the effectiveness of this treatment is only limited. Moreover, the pharmacotherapy can be hardly adapted to the patients because of the difficulty of recognizing their upcom- ing changes in state. A promising form of intervention is to teach patients to recognize and manage early warning signs (EWS) [2]. However it involves a very significant training effort and strongly depends on the patients compliance and discipline. Thus, this therapy is also of limited use only. A great improvement in managing bipolar disorder can be achieved with the use of wearable technology in support of both patients and doctors. Actually, thanks to the continuous advances in the development of technologies, such as sensing and communication, in parallel with the continuous progress of electronic device miniaturization, the wearable systems are becoming more and more a powerful support in health care. Today the wearable technology is envisioned for use in clinical applications [3] and personalized healthcare [4], where the wearable system became a part of a chain in which This work has been partially found by the EU Contract Number 248545 - MONARCA. Alessandro Puiatti is with Networking Laboratory, Institute of Infor- mation Systems and Netwrking, Department of Innovative Technolgies, University of Applied Sciences of Southern Switzerland, 6928 Manno, Switzerland alessandro.puiatti@supsi.ch Steven Mudda is with Networking Laboratory, Institute of Information Systems and Netwrking, Department of Innovative Technolgies, University of Applied Sciences of Southern Switzerland, 6928 Manno, Switzerland steven.mudda@supsi.ch Silvia Giordano is with Networking Laboratory, Institute of Information Systems and Netwrking, Department of Innovative Technolgies, University of Applied Sciences of Southern Switzerland, 6928 Manno, Switzerland silvia.giordano@supsi.ch Oscar Mayora is with CREATE-NET, 38123 Trento, Italy oscar.mayora@create-net.org all the other actors, patients, healthcare centres, and doctors are in a closed loop for better understanding, monitoring, pre- venting and treating the illness with a personalized approach. However, although the incredible technology advances in terms of device miniaturization, low power consumption and high computational power, the main challenges that a wearable system has to face with are always the same. In fact, the more the new technologies offer, the more the demand for new features and functionalities increases. So we are still to deal with low energy consumption [5] and minimally invasive systems development [6]. While the first constraint is independent from the clinical application, the second one applies differently depending on the disease to be treated. In fact, patients suffering from a cardiovascular disease can accept better to wear some bulky sensor on the skin than patients with mental disease. In the letter case not only the sensors cannot be accepted, but they can also affect the mood of the subject producing a biasing effect on the monitored data. To make the wearable system as minimally invasive as possible there are two lines of approach: embed all sensors in a garment [7][8], or move as much sensors as possible in wearable daily life equipments [9]. In this paper we present a solution that is a combination of the two approaches, which is intended for monitoring and treating patients affected by bipolar disorder. The system is a smartphone-centred and minimally invasive wearable sensor networks that is being developing in the framework of the MONARCA European Project [10]. The goals of the project are to develop and validate solutions for multi-parametric, long term monitoring of behavioural-physiological information relevant to bipolar disorder. These solutions will be deployed through an appro- priate healthcare platform providing a set of novel services for personalized management, treatment, and self-treatment of bipolar disorder. The architecture of the whole system is shown in Fig. 1. The rest of the paper is organized as follows. First we describe the MONARCA wearable system. In Section III we present the main challanges that the MONARCA system have to face with. Then, in Section IV, we briefly describe how the medical trials will be performed and finally, we present the conclusions. II. MONARCA WEARABLE SYSTEMS The main responsibility for the wearable system is to recognize the early warning signs in order to timely predict and prevent the occurrence of manic/depressive episodes, and to adjust the therapy accordingly. Therefore, the system must be capable of identifying, or at least has to be an aid for both patient and doctor to identify those signs that prelude the upcoming changes in patient’s mood: level of patient activity, 978-1-4244-4122-8/11/$26.00 ©2011 IEEE 3644 33rd Annual International Conference of the IEEE EMBS Boston, Massachusetts USA, August 30 - September 3, 2011