Abstract:
In a computer system having a storage device, a method for gathering clinical data useful in the clinical analysis and treatment of mood disorders. The method includes such steps as displaying a main menu including a multiplicity of icons depicting inquiries to be answered by a patient; and, storing the patient&#39;s answers to the inquiries as clinical data generated on a regular basis by the patient. The method further includes selecting a point on a scale depicting the patient&#39;s current mood; selecting a sleep icon for updating sleep data; and, selecting a medication icon for updating type and amount of medication taken. The present invention is also capable of creating longitudinal charts and statistics based on selections made by a patient over a given period of time.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     This Application claims the benefit of U.S. Provisional Patent Application, Serial No. 60/266,588, entitled System for Longitudinal Analysis of Bipolar Disorder, filed Feb. 6, 2001. 
    
    
     1. FIELD OF THE INVENTION 
     This invention relates in general to mental health, and in particular to a system and method useful in the treatment of mood disorders. 
     2. BACKGROUND OF THE INVENTION 
     A bibliography for the following text appears at the end of the specification and before the claims hereof. Mood disorders are mental illnesses in which a person experiences emotions outside the normal boundaries of sadness and elation. The most commonly occurring mood disorder is a major depressive disorder, which features one or more episodes of depression (APA 1994). Bipolar disorder features one or more episodes of mania or episodes of both mania and depression (APA 1994). Other mood disorders are dysthymia (persistent low-grade depression) and cyclothymia (mild moodswings). 
     Mood disorders occur commonly. In the USA, the National Comorbidity Study showed a lifetime prevalence of 17% for major depressive disorder and 1.6% for bipolar disorder (Kessler 1994). 
     Mood disorders are associated with high morbidity and mortality. Despite current treatments, episodes recur frequently. Following an initial episode, the probability of recurrence in major depressive disorder is 50-85% (Mueller 1999). In bipolar disorder, the probability of recurrence by 5 years is 90% (Tohen 1990). Dysthymia is associated with a marked increase in risk of developing major depressive episodes. (Keller Shapiro 1982). 
     Many patients do not obtain full recovery between episodes. In 20-30% of those with major depressive disorder, the depressive symptoms persist for longer than a year after treatment of the acute phase and 12% do not recover by 5 years (Keller 1992). In bipolar disorder, episodes of mania and depression are often protracted with 24% of patients remaining acutely ill after 1 year, 16% after 2 years and 9% after 5 years (Keller 1993). Many patients with depressive disorder or bipolar disorder report residual symptoms that impose considerable morbidity despite successful treatment (Fava 1999). As a consequence, many patients with bipolar disorder (Gitlin 1995) and major depressive disorder (Thase 1995) will develop a chronic and disabling course. Both major depressive disorder and bipolar disorder are among the top ten causes of worldwide disability (Murray 1996). 
     Mood disorders have a large economic impact on society. The costs of depression are estimated to be similar to those of cancer and ischemic heart disease, due to reduced productivity and increased use of healthcare resources (Greenberg 1993). A 1991 report from the National Institutes of Mental Health estimated the annual costs of bipolar disorder to be $45 billion (Wyatt 1991). 
     The disability and suffering in mood disorders impacts all aspects of life. Psychosocial impairment has been found to persist for years after an episode of mania or depression even for patients in remission (Coryell 1993). Mood disturbances are associated with high workplace absenteeism (Broadhead 1990) and poor well-being compared to those with chronic medical illnesses (Wells 1990). 
     Suicide is the most severe complication of mood disorders. Patients with major depressive disorder or bipolar disorder are more likely to attempt or complete suicide than any other medical group (Goodwin and Jamison 1990). A review of 31 studies of patients with major depressive disorder or bipolar disorder found a lifetime prevalence of suicide ranging from 9 to 60% (Goodwin and Jamison 1990). 
     The treatment of mood disorders is complex and usually requires a patient to take multiple medications several times a day. Maintenance therapy to prevent a recurrence of major depressive disorder may last several years or more. Maintenance therapy for bipolar disorder is usually for the patient&#39;s lifetime. 
     Most medications used to treat psychiatric disorders have uncomfortable side effects such as weight gain, tremors, hair loss and cognitive dulling. Although the combinations of drugs needed to treat mood disorders improve response, they also increase side effects and patient costs. Polypharmacy schedules can be difficult to adhere to. Thus, an understanding of the disorder and long-term commitment to the treatment is needed from the patient. Patient non-compliance with medication is a serious problem and the major factor that accounts for patient relapse. Studies show rates of non-compliance with maintenance therapy in between 24-53% of patients with major depressive or bipolar disorders (Schumann 1999, Simon 1993, Aagaard 1988, Berghofer 1996). 
     Daily patient self-reporting of mood and sleep is well established as a valuable clinical tool (Bauer 1991; Leverich and Post 1996). Mood disorders are characterized by rapid changes in mood making treatment decisions difficult. The prospective semi-continuous measure of infradian (daily or longer) fluctuations of patients&#39; mood and sleep allows for detailed assessment of frequency and pattern of illness (Denicoff 1997). Simultaneous comparison of daily mood fluctuations and medications may help to optimize and rationalize complex pharmacological therapy and to better detect nuances of partial response (Post 1997). Another benefit of daily self-reporting of mood is increased patient involvement in their care. 
     Two methodologies are currently used for daily patient self-reporting of mood: the Life Chart Methodology (Leverich and Post 1996) and the Chronosheet developed by Whybrow in the 1970s. The latter uses a 100-mm visual analogue scale (VAS) between the mood extremes of mania and depression on which the patient marks mood proportionately (Bauer M S 1991). The Chronosheet also records sleep, weight, psychiatric medications and life events. Both self-rating methodologies are paper and pencil based. The patient is given a form or booklet to complete by hand daily. The patient returns the completed form to staff monthly for data entry into a computer for analysis. There are several problems with a paper-based process. Data entry is very time-consuming and expensive. Overall data quality is negatively impacted by data entry errors. It is then necessary to manually digitize the VAS data for computer entry. Any data transformations performed by humans provide additional opportunities for error. 
     Accordingly, there is a need for a method and system to automate patient charting that is simple for patients to use and will provide physicians with an immediate display and data analysis of the results. More specifically, there is a need for an automated system that will record longitudinal data useful in the treatment of mood disorders, such as mood, sleep, medications, life events, weight changes and menstrual data. Moreover, there is a need for a system that will automatically provide a time-based visual display of the relationships between changes in mood, sleep, medications, life events, weight and menstrual data. 
     SUMMARY OF THE INVENTION 
     The present invention is a system and method for providing immediate longitudinal analysis of patient data to assist clinicians with treatment of mood disorders. Patients are enrolled in an administrative system on a computer at the physician&#39;s office. Patients are trained to install software on a home computer and then taught how to enter data accurately. A graphical user interface makes the software easy and fast for daily patient use. Patients enter their mood, sleep, medications taken, life events; and, if female menstrual data, every day and weight weekly. Patients without a home computer can use a computer at a mental health facility. Patients return data to the administrative system via E-Mail over the Internet or via diskette. Clinicians can obtain both descriptive charts and statistical analyses of all collected patient data in the administrative system. 
     This invention overcomes current deficiencies and allows a patient to enter daily mood and other clinical data directly into a home computer or into a computer at a mental health facility. 
     An advantage of the present invention is that clinicians can immediately obtain both descriptive charts and statistical analyses of the collected patient data to assist with clinical decision-making. 
     Another advantage of the present invention is that an automated charting system may be perceived by the patient more positively wherein one may be more apt to cooperate rather than with using a paper and pencil system, thereby improving compliance. 
     Another feature of the present invention is that data may be collected, displayed and analyzed in perpetuity for individual patients. Any time period in a patient&#39;s data can be selected for immediate display and analysis. 
     Another feature of the present invention is that data from multiple patients may be easily aggregated for use in clinical research. 
     These and other objects, which will become apparent as the invention is described in detail below, are provided in a computer system having a storage device, a method for gathering clinical data useful in the clinical analysis and treatment of mood disorders. The method includes such steps as displaying a main menu including a multiplicity of icons depicting inquiries to be answered by a patient; and, storing the patient&#39;s answers to the inquiries as clinical data generated on a regular basis by the patient. The method further includes selecting a point on a scale depicting the patient&#39;s current mood; selecting a sleep icon for updating sleep data; and, selecting a medication icon for updating type and amount of medication taken. The present invention is also capable of creating longitudinal charts and statistics based on selections made by a patient over a given period of time. 
     Still other objects, features and advantages of the present invention will become readily apparent to those skilled in the art from the following detailed description, wherein is shown and described only the preferred embodiment of the invention, simply by way of illustration of the best mode contemplated of carrying out the invention. As will be realized, the invention is capable of other and different embodiments, and its several details are capable of modifications in various obvious respects, all without departing from the invention. Accordingly, the drawings and description are to be regarded as illustrative in nature, and not as restrictive, and what is intended to be protected by Letters Patent is set forth in the appended claims. The present invention will become apparent when taken in conjunction with the following description and attached drawings, wherein like characters indicate like parts, and which drawings form a part of this application. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The general purpose of this invention, as well as a preferred mode of use, its objects and advantages will best be understood by reference to the following detailed description of an illustrative embodiment with reference to the accompanying drawings in which like reference numerals designate like parts throughout the figures thereof, and wherein: 
     FIG. 1 is a pictorial representation of a data processing system used to implement a method and system of the present invention. 
     FIG. 2 is a block diagram of the overall method for providing longitudinal analysis of mood disorders. 
     FIG. 3 is a high-level flow chart illustrating the operation of the program a patient installs on their home computer to enter data daily. 
     FIG. 4 is a more detailed flow chart of a portion of the method of FIG.  3 . 
     FIG. 5 is a high-level flow chart illustrating the operation of the administrative system program that is installed on a workstation in the physician&#39;s office; 
     FIG. 6 is a more detailed flow chart of a portion of the method of FIG.  5 . 
     FIG. 7 is a high-level flow chart illustrating the operation of the program patients use to enter data in a workstation in a mental health clinic. 
     FIG. 8 is a high-level flow chart illustrating the operation of the program used to aggregate patient data from multiple sources for research. 
     FIG. 9 illustrates the main menu of the patient data entry program of the present invention. 
     FIG. 10 illustrates the mood dialog box of the patient data entry program of the present invention. 
     FIG. 11 illustrates the sleep dialog box of the patient data entry program of the present invention. 
     FIG. 12 illustrates the medications dialog box of the patient data entry program of the present invention. 
     FIG. 13 is an exemplary 30-day printed mood chart created by the present invention. 
     FIG. 14 is an exemplary 120-day printed mood chart created by the present invention. 
     FIG. 15 is an exemplary 120-day, 7-day period statistical mood chart created by the present invention. 
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     FIG. 1 depicts the components of an example system  100  for longitudinal analysis of mood disorders. At a central physician&#39;s office  101  the system  100  for longitudinal analysis of mood disorders contains computers used for training patients  102 , system administration  103  and for aggregating data from multiple patients and from multiple sites  104 . Another physician office  105  may have a computer with a training system  102  and a computer  103  for system administration. The system administration computer  103  is used to enroll patients, receive and analyze data and display or print reports. The training computer  102  is used to train patients on how to install and use the software at home or at a clinic. Mental health providers, such as a day treatment facility  110 , contain clinic system computers  111  for data entry by patients who do not have a computer at home. Patients with a computer at home  108  install a patient data entry system software  109 . Every day patients enter mood data directly onto the software on their home computer  109 . Patients return data to the system administration computer  103  at the physician&#39;s office  101  or  105 , by E-Mail over the Internet  107  or via diskette  106 . Patient data from clinic systems computers  111  likewise is returned to the system administration computer  103  by E-Mail over the Internet  107  or via diskette  106 . After patient data is returned, mood charts and statistical charts are displayed or printed on the system administration computer  103  in the physician&#39;s office  101  or  105 . 
     If the patient data collection is part of a research study, data from all physician office sites  105  is returned to the aggregate system  104  in the central physician&#39;s office  101  by E-mail over the Internet  107  or via diskette  106 . The aggregate system  104  will merge the data of all patients from all sites, remove all patient identifiers and format the output file for analysis in commercial programs. 
     FIG. 2 illustrates a method to provide longitudinal analysis of mood disorders in accordance with the present invention. The system  100  of FIG. 1 can be used to implement the method of FIG.  2 . The first step is to verify the patient&#39;s diagnosis (step  200 ) to ensure that the patient has a mood disorder. After determining the patient is an appropriate candidate for mood charting, the configuration of the computer the patient has at home is verified (step  201 ). If the configuration of the home computer is adequate, the patient is trained to use the software (step  202 ) at the physician&#39;s office. The training includes a demonstration of how to install the software on a home computer, instructions on how to enter data accurately and an overview of mood charting. Next, the patient is enrolled (step  203 ) on the system administrator computer ( 103  of FIG.  1 ). The patient is then given software to install on their home computer (step  204 ). The patient installs the software on a home computer and enters data every day (step  205 ). Every month, or at a frequency determined by their physician, the patient returns data to the system administrator computer ( 103  of FIG.  1 ), either by E-Mail over the Internet or by diskette (step  206 ). The data from the patient is analyzed and reports are displayed and printed (step  207 ). If the patient is part of a research study, data from the physician site can be aggregated with data from other patients and study sites for statistical analysis (step  208 ). 
     FIGS. 3 and 4 are high-level flowcharts that refer to the operation of the software of the present invention, which is installed on a patient&#39;s computer at home. The process begins with a start bubble  300 . The patient starts up the software and enters their password. The process then decrypts the patient&#39;s data file and verifies that the password is correct (block  301 ). After this, the main menu is displayed (block  302 ) and updates are made to the entry status for the current date. The entry status graphically displays whether the patient completed entry of all required data in each major section (mood, sleep, and medications). 
     An inquiry is then made to determine if the date is being changed (diamond  303 ). If the response is no, the process proceeds to the next step depicted by a block  306 . If the response to decision block  303  is yes, block  304  verifies the new date selected. Any data previously entered for the selected date is retrieved and the entry status reset accordingly at block  305 . 
     Block  306  allows entry of a day of data as in FIG.  4 . Decision block  308  checks if the data is to be exported back to the clinic for analysis. If the response to decision block  308  is yes, block  309  encrypts all the patient&#39;s data for export by E-mail via Internet or by diskette. If the response to decision block  308  is no, the process proceeds to block  310  where the patient exits the program and data is encrypted and saved. 
     At connector A of FIG. 4, the process allows the entry of a day of data. Decision block  401  selects the main menu choice to allow entry of mood data. If the response to decision block  401  is no, the process proceeds to a decision block  404 . On the other hand, if the response to decision block  401  is yes, the mood dialog box will appear and decision block  402  verifies that all required data has been entered. 
     Mood data is entered using a VAS scale between 0 and 100. The most extreme feelings of depression and mania the patient has ever experienced define the anchor points. The patient slides the scale to the number that best represents mood over the past 24 hours, in relation to these anchor points. Other data entered here are optionally any significant life events and, if female, menstrual data. If the response to decision block  402  is no, the process returns to decision block  401  to allow re-entry of the data. If the response to decision block  402  is yes, the data entry status for the mood section for the current date is updated to complete at block  403 . The process proceeds to decision block  404 . 
     Decision block  404  selects the main menu choice to allow entry of sleep data. If the response to decision block  404  is no, the process proceeds to decision block  407 . On the other hand, if the response to decision block  404  is yes, the sleep dialog box will appear and decision block  405  will verify that all required data has been entered. For each hour of the day, a graphical toggle switch is used to select if awake, asleep or in bed and awake. If the response to decision block  405  is no, the present process returns to decision block  404  to allow re-entry of the data. On the other hand, if the response to decision block  405  is yes, the data entry status for the sleep section for the current date is updated to complete at block  406 . Then the process proceeds to decision block  407 . 
     Decision block  407  selects the main menu choice to allow entry of medication data. If the response to decision block  407  is no, the process proceeds to decision block  400  (FIG. 3) as denoted by the connector A. On the other hand, if the response to decision block  407  is yes, the medications dialog box will appear and decision block  408  will verify that all required data has been entered. Medications are displayed by trade and generic name, as well as strength. For each medication displayed, data is entered by the count of pills taken for the day. The strength of each pill and the number of pills can be changed. Current medications can be deleted and new medications can be selected from an internal list of psychotropic medications. If the response to decision block  408  is no, the process returns to decision block  400  (FIG. 3) to allow re-entry of the data. On the other hand, if the response to decision block  408  is yes, the data entry status for the medications section for the current date is updated to complete at block  409 . Then the process proceeds to block  307  (i.e., connector A) of FIG.  3 . 
     FIGS. 5 and 6 are high-level flow charts that refer to the operation of the administrative system of the present invention, which is installed on a computer in the physician&#39;s office. In FIG. 5, block  501  validates the user&#39;s password. Decision block  502  allows changes to the system configuration. If the response to decision block  502  is no, the process proceeds to decision block  504 . On the other hand, if the response to decision block  502  is yes, block  503  sets system parameters including system demographics, physician names, printing in color and use of pounds or kilograms. 
     Decision block  504  asks if there is a new patient to enroll in the system. If the response to decision block  504  is no, the process proceeds to decision block  507 . On the other hand, if the response to decision block  504  is yes, a new patent is enrolled in block  505 . Enrollment includes entering patient demographic information and defining patient specific anchor points on the mood scale. The patient selects a password that is easy to remember. Block  506  exports a patient specific file required for installation of the software on the patient&#39;s home computer or on a clinic system. 
     Decision block  507  allows patient demographic data to be modified. This does not refer to the daily mood data entered by the patient at home. This refers to patient demographic, diagnostic data (DSM-IV diagnoses with specifiers) entered during enrollment and test results (HAMD, YMRS, BDI, etc). If the response to decision block  507  is no, the process proceeds to decision block  509 . On the other hand, if the response to decision block  507  is yes, block  508  modifies, adds and deletes patient data. 
     Decision block  509  checks if there is patient data ready for importing. If the response to decision block  509  is no the process proceeds to decision block  511 . On the other hand, if the response to decision block  509  is yes, block  510  validates the import file and adds the data to the patient&#39;s folder. 
     Decision block  511  allows display and printing of mood charts as in FIG.  6  and denoted by a connector B. Block  601  sets the desired time duration of the mood chart. The duration may be 30, 60, 90 or 120 days. Decision block  602  allows the most recent days that meet the specified duration to be used. If the response to decision block  602  is no, the process proceeds to block  604 . On the other hand, if the response to decision block  602  is yes, the most recent days that meet the specified duration are set. 
     Block  604  sets the starting date for the mood chart. Decision block  605  selects statistical charts. If the response to decision block  605  is no, the process proceeds to block  608 . On the other hand, if the response to decision block  605  is yes, block  606  sets the period used for the statistical calculations to either 7 or 30 days. Block  607  makes the statistical calculations. 
     Block  608  sets the drug legend that annotates which medications the patient was taking. Decision block  609  determines if the mood chart should be printed. If the response to decision block  609  is no, the process proceeds to block  611 . On the other hand, if the response to decision block  609  is yes, mood charts are printed at block  610 . Block  611  displays the mood charts on the screen. Block  600  returns to FIG. 5 at the connector B. 
     Decision block  513  determines whether or not printing of patient reports on demographic, diagnostic and test result data is to be made. If the response to decision block  513  is no, the process proceeds to block  515 . On the other hand, if the response to decision block  513  is yes, reports can be selected and printed (block  514 ). Thereafter the process exits (block  515 ). 
     FIG. 7 is a high-level flow chart illustrating the operation of the program patients use to enter data on a computer in a mental health clinic. At block  701 , the patient enters their name. Decision block  702  verifies the name is in the system. If the response to decision block  702  is yes, the process proceeds to block  705 . On the other hand, if the response to block  702  is no, decision block  703  checks if this is a new user. If the response to decision block  703  is no, the system returns to block  701  for re-entry of the name. On the other hand, if the response to decision block  703  is yes, block  704  loads the program diskette and the patient is installed as a new user. After installation, the system returns to block  705 . 
     Block  705  allows entry of patient data in a fashion identical to that described in FIG.  3  and FIG.  4 . After data entry is finished in block  706  wherein the patient data is encrypted and saved; thereafter the process exits (bubble  707 ). 
     FIG. 8 is a high-level flow chart illustrating the operation of the process used to aggregate patient data from multiple sources for research. The step depicted by a block  801  configures the aggregate system including setting the data path, and making all data anonymous (removing all fields that contain patient identifying information). At the step depicted by the block  802 , the name of the file to be included is input, along with the input password and input site name. Decision block  803  finds the file described in block  802 . If the response to decision block  803  is no, the system returns to block  802 . If the response to decision block  803  is yes, the process proceeds to decision block  804  to check if there are more input files to merge. If the response to decision block  804  is yes, then the process returns to block  802 . On the other hand, if the response to decision block  804  is no, block  805  selects a database, spreadsheet or text file output format for the aggregated data. The format selected will allow the aggregated data to load directly into popular spreadsheets, databases or statistical programs for analysis. Block  806  generates the output file of the aggregated data; thereafter the process exits (bubble  807 ). 
     FIGS. 9 through 12 illustrate the screens used by the patient to enter data daily on a home computer. FIG. 9, view  900  shows the main menu screen with a graphical button to select all activities: change the date icon  901 , record mood icon  902 , record sleep pattern icon  903 , record medications icon  904 , online help icon  905 , manage data icon  906  and exit icon  907 . 
     FIG. 10 shows an example of the mood dialog box for a female with VAS scale  1001  for entering mood, window  1002  shows the optional significant life events field, window  1003  is used for weight entry and buttons  1004  are used for answering the question regarding whether or not the patient is having a period today. 
     FIG. 11 shows an example of the sleep dialog box with the  24  toggle switches  1101 . The positions of the switch are as follows: awake icon  1102 , in bed and asleep icon  1103  and in bed but awake icon  1104 . 
     FIG. 12 shows an example of the medication dialog box with medication name and strength  1201  and number of pills taken  1202 . 
     FIGS. 13 through 15 illustrate exemplary mood charts. On all of the charts, the data is displayed in three graphs: Mood versus Time, Sleep versus Time and Medications versus Time. All three graphs are directly aligned on the same horizontal axis equal to the time period selected for the chart (30, 60, 90, 120 or 180 days). For FIG. 13, 30 days is the selected time period. For FIGS. 14 and 15, 90 days is the selected time period. 
     Mood Versus Time Graph 
     In FIG. 13, mood chart  1300 , the top graph Mood versus Time  1301  shows mood data over the 30-day time period selected. The vertical axis  1302  ranges between 0 and 100 with 50 representing normal mood, 0 the most depressed the patient has ever been and 100 the most manic the patient has ever been. Triangles  1303  show the mood value entered daily. The daily values are connected with a line  1304 . Along the top of the graph, the patient&#39;s weight  1306  is entered once a week. If the patient entered a significant life event  1305 , the date is outlined by a square on the horizontal axis. For female patients, days of menstrual period  1307  are outlined by an inverted triangle on the horizontal axis. 
     Sleep Versus Time Graph 
     The middle graph Sleep versus Time  1308  shows patient sleep data over the 30-day period selected. The vertical axis  1309  ranges between 0 and the total number of hours the patient was asleep plus in bed awake for the time period selected. The daily hours asleep  1310  are displayed as a dark colored bar topped by a lighter colored bar containing for any hours in bed awake  1311 . 
     Medications Versus Time Graph 
     The bottom graph Medications versus Time  1312  shows which medications were taken each day by the patient for the time period selected. The vertical axis  1313  represents each of the different pills taken by the patient during the time period selected. Different pills may represent different medications or different strengths of the same medication. 
     A colored box appears for each medication  1314 . The medications are displayed in the same color on all charts, arranged in medication class order alphabetically within each class. On the 30-day graph, the number of pills taken daily for each medication is shown in the middle of the color box  1314 . 
     The specific medications are shown in the drug legend  1315 . The numbers in the legend  1315  correspond to the numbers on the vertical axis of the graph  1313 . Each number in the legend  1315  lists the specific medication and strength taken by the patient. 
     FIG. 14, mood chart  1400 , is an example of a mood chart that extends for a 90-day period. The only difference from FIG. 13 is that the number of pills does not appear on the medication box  1401 . 
     FIG. 15, mood chart  1500 , is an example of a statistical chart calculated for a 7-day period and extending for 90 days. The statistical charts contain three graphs: Mood versus Time, Sleep versus Time and Medications versus Time. All three graphs are aligned on the same horizontal axis with the total number of days displayed. Calculations can be made for a 7 or 30-day period. The results are positioned in the middle of the period. For the 7-day period, the period extends from 3½ days before to {fraction (3/12)} days after the displayed result. 
     Mood Versus Time Graph 
     The top graph Mood versus Time  1501  shows statistics based on mood data, calculated for a 7-day period. The vertical axis  1502  ranges between 0 and 100 with 50 representing normal mood. The 0 represents the most depressed while 100 represents the most manic the patient has ever been. 
     For each 7-day time period the following statistics are calculated: 
     
       
         
               
               
               
             
           
               
                   
                   
               
               
                   
                 Statistics Calculated 
                   
               
               
                   
                 for Mood Data 
                 Explanation 
               
               
                   
                   
               
             
             
               
                   
                 Maximum mood 
                 Largest value entered for 
               
               
                   
                   
                 mood. 
               
               
                   
                 Mean mood 
                 Average value entered for 
               
               
                   
                   
                 mood. 
               
               
                   
                 Minimum mood 
                 Smallest value entered for 
               
               
                   
                   
                 mood. 
               
               
                   
                 Percent change in mean mood 
                 Percent change in mean mood 
               
               
                   
                   
                 from the prior period. 
               
               
                   
                 Number of mood switches 
                 The number of times the mood 
               
               
                   
                   
                 value crosses 50. 
               
               
                   
                 Standard deviation 
                 A measure of the variability 
               
               
                   
                   
                 of the values entered. 
               
               
                   
                   
               
             
          
         
       
     
     For each 7-day calculation, at least 5 days of mood data are required or the result is left blank. For each 30-day calculation, at least 20 days of mood data were entered or the result is left blank. For the count of mood switches, one or more blanks will restart the count. 
     In the middle of each 7-day period, the maximum mood will appear as an inverted triangle  1503 , mean mood as a square  1504 , and minimum mood as a triangle  1505 . A dotted line connects the values in each period:  1507  connects the maximum mood from period to period,  1508  connects the mean mood from period to period and  1509  connects the minimum mood from period to period. Standard deviation  1506  is shown as a circle. A dotted line  1510  connects the standard deviation from period to period. On the top of the graph is the number of mood switches in the time period  1511 , above the percent change in mean mood from period to period  1512 . 
     Sleep Versus Time Graph 
     The middle graph  1513  shows statistics based on sleep data calculated for either a 7-day period and extending for either 60 or 90 days. The vertical axis  1514  ranges between 0 and the total number of hours the patient was asleep. 
     For each time period the following statistics are calculated: 
     
       
         
               
               
               
             
           
               
                   
                   
               
               
                   
                 Statistics Calculated 
                   
               
               
                   
                 for Sleep Data 
                 Explanation 
               
               
                   
                   
               
             
             
               
                   
                 Maximum sleep 
                 Largest number of hours 
               
               
                   
                   
                 asleep. 
               
               
                   
                 Mean sleep 
                 Average number of hours 
               
               
                   
                   
                 asleep. 
               
               
                   
                 Minimum sleep 
                 Smallest number of hours 
               
               
                   
                   
                 asleep. 
               
               
                   
                 Percent change in mean sleep 
                 Percent change in average 
               
               
                   
                   
                 number of hours asleep from 
               
               
                   
                   
                 the last period. 
               
               
                   
                 Standard deviation 
                 A measure of the variability 
               
               
                   
                   
                 of the values entered. 
               
               
                   
                   
               
             
          
         
       
     
     For each 7-day calculation, at least 5 days of sleep data are required or the result is left blank. For each 30-day calculation, at least 20 days of sleep data are required or the result is left blank. 
     In the middle of each 7-day period, the maximum sleep will appear as an inverted triangle  1515 , mean sleep as a square  1516 , and minimum sleep as a triangle  1517 . A dotted line connects the values in each period:  1519  connects the maximum sleep from period to period,  1520  connects the mean sleep from period to period and  1521  connects the minimum sleep from period to period. Standard deviation  1518  is shown as a circle. A dotted line  1522  connects the standard deviation from period to period. 
     Medications Versus Time Graph 
     The bottom graph  1524  shows statistics based on medication data, calculated for either a 7-day period and extending for 120 days. The vertical axis  1525  represents each different medication taken. The drug legend  1527  numbers correspond to the numbers on the vertical axis of the graph  1525 . Each number in the drug legend  1527  lists the specific medication and strength taken. 
     For each time period, the average dosage taken for each medication is calculated  1526 . The calculations will include all strengths for the same medication. No averages are calculated for birth control pills, dermal patches or combination drugs. 
     For each 7-day calculation, at least 5 days of drug data were entered or the result is left blank. For each 30-day calculation, at least 20 days of drug data were entered or the result is left blank. 
     The methods and apparatus of the present invention, or certain aspects or portions thereof, may take the form of program code (i.e., instructions) embodied in tangible media, such as floppy diskettes, CD-ROMS, hard drives, or any other machine-readable storage medium, wherein, when the program code is loaded into and executed by a machine, such as a computer, the machine becomes an apparatus for practicing the invention. The methods and apparatus of the present invention may also be embodied in the form of program code that is transmitted over some transmission medium, such as over electrical wiring or cabling, through fiber optics, or via any other form of transmission, wherein, when the program code is received and loaded into and executed by a machine, such as a computer, the machine becomes an apparatus for practicing the invention. When implemented on a general-purpose processor, the program code combines with the processor to provide a unique apparatus that operates analogously to specific logic circuits. 
     Although the invention has been described with reference to a specific embodiment, this description is not meant to be construed in a limiting sense. Various modifications of the disclosed embodiment as well as alternative embodiments of the invention will become apparent to one skilled in the art upon reference to the description of the invention. It is therefore contemplated that the appended claims will cover any such modifications of embodiments that fall within the true scope of the invention. 
     BIBLIOGRAPHY 
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