U.S. patent application number 16/030213 was filed with the patent office on 2018-11-01 for mental health assessment method and kiosk-based system for implementation.
The applicant listed for this patent is MOREHOUSE SCHOOL OF MEDICINE. Invention is credited to Glenda Wrenn.
Application Number | 20180310866 16/030213 |
Document ID | / |
Family ID | 61902416 |
Filed Date | 2018-11-01 |
United States Patent
Application |
20180310866 |
Kind Code |
A1 |
Wrenn; Glenda |
November 1, 2018 |
MENTAL HEALTH ASSESSMENT METHOD AND KIOSK-BASED SYSTEM FOR
IMPLEMENTATION
Abstract
A method and system for assessing the mental state or behavioral
disorder of a subject is disclosed. The system includes a display,
an input device, a processor, a database and matrix for converting
the responses to one or more assessment scores. The disclosure also
relates to a method for treating a behavioral disorder using the
method and a system described herein.
Inventors: |
Wrenn; Glenda; (Atlanta,
GA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
MOREHOUSE SCHOOL OF MEDICINE |
Atlanta |
GA |
US |
|
|
Family ID: |
61902416 |
Appl. No.: |
16/030213 |
Filed: |
July 9, 2018 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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15295489 |
Oct 17, 2016 |
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16030213 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 5/16 20130101; G16H
10/20 20180101; A61B 5/6888 20130101; G16H 50/30 20180101; G16H
20/70 20180101; A61B 5/4088 20130101; A61B 5/742 20130101; G16H
10/60 20180101; A61B 5/0022 20130101; A61B 5/746 20130101 |
International
Class: |
A61B 5/16 20060101
A61B005/16; G16H 10/20 20060101 G16H010/20; A61B 5/00 20060101
A61B005/00 |
Claims
1. A method for assessment of a mental state of a human subject,
the method comprising: prompting the subject with at least one
question on a display of a system for assessment of the mental
state of the subject; recording at least one response to the at
least one question in the system; calculating an assessment score
based on the at least one response, wherein the at least one
response comprises a long form answer; determining by at least one
health professional, based on the at least one response and/or the
assessment score, the mental state of the subject; incorporating
the mental state of the subject into an electronic health record
associated with the subject; retrieving a medical history of the
subject from a database and accepting at least one attribute from
the medical history for the determination of the mental state of
the subject, and/or presenting one or more questions about the
medical history of the subject and receiving at least one response
to the one or more questions about the medical history of the
subject for the determination of the mental state of the subject,
wherein the at least one attribute from the medical history and/or
the at least one response to the one or more questions about the
medical history triggers the system to present an automatic alert
for review by the at least one health professional if the at least
one attribute from the medical history and/or the at least one
response to the one or more questions about the medical history
matches an alert event in an alert database; and wherein the at
least one response comprises a long-form answer and wherein the
system comprises the display, an input device, a processer, a
database and a matrix for converting the at least one response to
an assessment score.
2. The method of claim 1, comprising analyzing the at least one
response by two health professionals.
3. The method of claim 2, wherein at least one health professional
is a mental health professional.
4. The method of claim 2, wherein at least one health professional
is a physician.
5. The method of claim 2, wherein the two health professionals are
a physician and a mental health professional.
6. The method of claim 5, wherein the physician is a primary care
physician of the subject.
7. The method of claim 1, wherein the determined mental state is a
behavioral disorder selected from the group consisting of
depression, substance abuse, risk for bipolar disorder, and
post-traumatic stress disorder.
8. The method of claim 1, further comprising: collecting
demographic information regarding the subject.
9. The method of claim 1, wherein the mental state of the subject
is determined based on the assessment score.
10. The method of claim 1, wherein a depression severity
questionnaire is presented to the subject when the assessment score
indicates the presence of depression in the subject.
11. A method for treating a behavioral disorder in a subject in
need thereof, the method comprising: prompting the subject with at
least one question on a display of a system for assessment of a
behavioral disorder of the subject; recording at least one response
to the system, wherein the at least one response comprises a
long-form answer; analyzing the at least one response by at least
one health professional; determining by the at least one health
professional, based on the at least one response, the behavioral
disorder of the subject; and incorporating the behavioral disorder
of the subject into an electronic health record associated with the
subject; retrieving a medical history of the subject from a
database and accepting at least one attribute from the medical
history for the determination of the behavioral disorder of the
subject, and/or presenting one or more questions about the medical
history of the subject and receiving at least one response to the
one or more questions about the medical history of the subject for
the determination of the behavioral disorder of the subject,
wherein the at least one attribute from the medical history and/or
the at least one response to the one or more questions about the
medical history triggers the system to present an automatic alert
for review by the at least one health professional if the at least
one attribute from the medical history and/or the at least one
response to the one or more questions about the medical history
matches an alert event in an alert database; and administering to
the subject at least one treatment effective for the behavioral
disorder, wherein the system comprises the display, an input
device, a processer and a database.
12. The method of claim 11, comprising analyzing the at least one
response by two health professionals.
13. The method of claim 12, wherein at least one health
professional is a mental health professional.
14. The method of claim 12, wherein at least one health
professional is a physician.
15. The method of claim 12, wherein the two health professionals
are a physician and a mental health professional.
16. The method of claim 11, further comprising: converting the at
least one response into an assessment score based on a matrix.
17. A system for assessment of a mental state of a subject, the
system comprising: a computer-readable memory, the
computer-readable memory configured to store computer-executable
instructions; an input device configured to receive an input from
the subject; and a processor configured to execute the
computer-executable instructions, the computer-executable
instructions comprising: prompting the subject with at least one
question in a system for assessment of mental state on a display;
recording at least one response to the at least one assessment,
wherein the at least one response comprises a long-form answer;
converting the at least one response into at least one assessment
score; generating an output comprising the at least one assessment
score for assessment of the mental state of the subject by at least
one health professional, retrieving a medical history of the
subject from a database and accepting at least one attribute from
the medical history for the determination of the mental state of
the subject, and/or presenting one or more questions about the
medical history of the subject and receiving at least one response
to the one or more questions about the medical history of the
subject for the determination of the mental state of the subject,
wherein the at least one attribute from the medical history and/or
the at least one response to the one or more questions about the
medical history triggers the system to present an automatic alert
for review by the at least one health professional if the at least
one attribute from the medical history and/or the at least one
response to the one or more questions about the medical history
matches an alert event in an alert database; and generating a
report of the mental state of the subject based on the assessment
by the at least one health professional and incorporating the
report into an electronic health record associated with the
subject.
18. The system of claim 17, wherein the computer-executable
instructions further comprise: collecting demographic information
regarding the user.
Description
[0001] This application is a division of U.S. application Ser. No.
15/295,489, filed Oct. 17, 2016. The entirety of the aforementioned
applications is incorporated herein by reference.
FIELD
[0002] This disclosure is generally related to systems and methods
for assessing health. More specifically, this disclosure is related
to systems and methods for assessing or determining a mental state
of a subject using a kiosk.
BACKGROUND
[0003] The 16th Surgeon General's report on mental health reported
that mental health is fundamental and that mental disorders are
real health conditions. However, since that report, systems for
addressing mental disorders remain challenging and often provide
unequal opportunities and unequal outcomes.
[0004] One aspect of assessing or determining a mental state of a
subject is that health care professionals have a limited time with
each subject to collect information and provide medical services
and/or guidance. In collecting information, behavioral health and
social history are often missed. These are often missed because
they are more time-consuming to collect and the answers are often
more sensitive. Moreover, research has shown that subjects are more
likely to disclose sensitive information to a computer rather than
to staff. Subjects also often spend a considerable amount of time
in a waiting room to see a health care professional. Having
subjects provide behavioral health and social history information
while they are waiting would increase the efficiency of health care
delivery.
[0005] Accordingly, there is a need for systems and methods to
collect behavioral health and social history information in a
sensitive and effective manner to increase efficiency of health
care delivery.
[0006] The present application fulfills a need for a system and
method for collecting information from a subject for mental health
evaluation of the information by healthcare professionals to
determine the mental competency of the subject and/or the need for
treatment of a subject for a behavioral disorder.
SUMMARY
[0007] One aspect of the present application relates to a method
for assessment of a mental state of a human subject. The method
includes the steps of: prompting the subject with at least one
question on a display of a system for assessment of the mental
state of the subject; recording at least one response to the at
least one question in the system; calculating an assessment score
based on the at least one response; determining by at least one
health professional, based on the at least one response and/or the
assessment score, the mental state of the subject; and
incorporating the mental state of the subject into an electronic
health record associated with the subject, wherein the at least one
response comprises a long-form answer and wherein the system
comprises the display, an input device, a processer, a database and
a matrix for converting the at least one response to an assessment
score.
[0008] Another aspect of the present application relates to a
method for treating a behavioral disorder in a subject in need
thereof. The method comprises the steps of: prompting the subject
with at least one question on a display of a system for assessment
of a behavioral disorder of the subject, wherein the system
comprises the display, an input device, a processer and a database;
recording at least one response to the system, wherein the at least
one response comprises a long-form answer; analyzing the at least
one response by at least one health professional; determining by
the at least one health professional, based on the at least one
response, the mental state or behavioral disorder of the subject;
and incorporating the mental state or behavioral disorder of the
subject into an electronic health record associated with the
subject. The method further comprises administering to the subject
at least one treatment effective for the behavioral disorder. By
incorporating the mental state or behavioral state of the subject
in an electronic health record, the present application provides a
means for alerting authorities concerning potential dangers or
risks associated with owning and/or operating firearms, motor
vehicles, etc.
[0009] In some embodiments, the method further comprises the step
of retrieving a medical history of the subject from a database and
accepting the at least one attribute from the medical history for
the determination of the mental state or behavioral disorder of the
subject. In some embodiments, the method further comprises the step
of presenting one or more questions about the medical history of
the subject and receiving responses to the one or more questions
about the medical history of the subject for the determination of
the mental state or behavioral disorder of the subject.
[0010] In some embodiments, the at least one attribute from the
medical history and/or the at least one response to the one or more
questions about the medical history triggers an automatic alert for
review by the at least one health professional if the at least one
attribute from the medical history and/or the at least one response
to the one or more questions about the medical history matches an
alert event in an alert database.
[0011] Still another aspect of the present application relates to a
system for assessing the mental state of a subject. The system
comprises: a computer-readable memory, the computer-readable memory
configured to store computer-executable instructions; an input
device configured to receive an input from the subject; and a
processor configured to execute the computer-executable
instructions, the computer-executable instructions comprising:
prompting the subject with at least one question in a system for
assessment of mental state on a display; recording at least one
response to the at least one assessment, wherein the at least one
response comprises a long-form answer; converting the at least one
response into at least one assessment score; generating an output
comprising the at least one assessment score for assessment of the
mental state of the subject by at least one health professional,
generating a report of the mental state of the subject based on the
assessment by the at least one health professional and
incorporating the report into an electronic health record
associated with the subject.
[0012] In some embodiments, the processor is configured to execute
additional computer-executable instructions, including the step of
retrieving a medical history of the subject from a database and
accepting the at least one attribute from the medical history for
the determination of the mental state of the subject. In some
embodiments, the processor is configured to execute additional
computer-executable instructions, including the step of presenting
one or more questions about the medical history of the subject and
receiving responses to the one or more questions about the medical
history of the subject for the determination of the mental state of
the subject.
[0013] In some embodiments, the at least one attribute from the
medical history and/or the at least one response to the one or more
questions about the medical history triggers the system to present
an automatic alert for review by the at least one health
professional if the at least one attribute from the medical history
and/or the at least one response to the one or more questions about
the medical history matches an alert event in an alert
database.
[0014] In some embodiments, the system further comprises a database
of alert events, wherein a response to the at least one question,
and/or an attribute of a medical history of the subject, triggers
the system to present an automatic alert for review by the at least
one health professional if the response and/or the attribute
matches an alert event in the database.
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] The present invention can be better understood by reference
to the following drawings, wherein like references numerals
represent like elements. The drawings are merely exemplary to
illustrate certain features that may be used singularly or in any
combination with other features and the present invention should
not be limited to the embodiments shown.
[0016] FIG. 1 is a block diagram illustrating exemplary hardware
components that may be used for implementing aspects of the
system.
[0017] FIGS. 2A and 2B show an exemplary method of using the
wellness assessment behavioral health kiosk.
[0018] FIG. 3 shows another exemplary method of using the wellness
assessment behavioral health kiosk.
DETAILED DESCRIPTION
[0019] The following detailed description is presented to enable
any person skilled in the art to make and use the object of this
application. For purposes of explanation, specific nomenclature is
set forth to provide a thorough understanding of the present
application. However, it will be apparent to one skilled in the art
that these specific details are not required to practice the
subject of this application. Descriptions of specific applications
are provided only as representative examples. The present
application is not intended to be limited to the embodiments shown,
but is to be accorded the widest possible scope consistent with the
principles and features disclosed herein.
[0020] This description is intended to be read in connection with
the accompanying drawings, which are to be considered part of the
entire written description of this application. The drawing figures
are not necessarily to scale and certain features of the
application may be shown exaggerated in scale or in somewhat
schematic form in the interest of clarity and conciseness.
[0021] As used herein, the term "mental health" relates to the
psychological well-being of a subject. According to the World
Health Organization (WHO), mental health includes "subjective
well-being, perceived self-efficacy, autonomy, competence,
inter-generational dependence, and self-actualization of one's
intellectual and emotional potential, among others" (World Health
Organization, "World Health Report 2001: Mental Health: New
Understanding, New Hope," 2001). The WHO further states that the
well-being of an individual is encompassed in the realization of
their abilities, coping with normal stresses of life, productive
work and contribution to their community.
[0022] As used herein, the terms "mental illness," "mental
disorder", "behavioral disorder" and "psychiatric disorder" relate
to mental health conditions comprising a disorder in the mood,
thinking or behavior of a subject. Mental illnesses or behavioral
disorders commonly present with cognitive deficits and mood
dysregulation. Mental illnesses or behavioral disorders are
generally defined by a combination of how a person feels, acts,
thinks or perceives. Well established systems for the
classification of mental illnesses or behavioral disorders include
the International Statistical Classification of Diseases and
Related Health Problems, 10th Revision (World Health Organization,
tenth revision (2010), the content of which is hereby expressly
incorporated by reference in its entirety for all purposes) and the
Diagnostic and Statistical Manual of Mental Disorders (fifth
edition, DSM-5; American Psychiatric Association, (2013), the
content of which is hereby expressly incorporated by reference in
its entirety for all purposes). Common examples of mental illnesses
or behavioral disorders include schizophrenia, Alzheimer's disease,
Huntington's disease, Cushing's disease, Lewy body disease,
multiple sclerosis, stroke, addictive disorder, pervasive
development disorder, autism, fragile X syndrome, anxiety disorder,
mood disorders, Prader-Willi syndrome, bipolar disorder, depressive
disorders, behavioral disorders, eating disorders, vascular
dementia, mild cognitive impairment, autism, dementia and delirium.
The mental illnesses or behavioral disorders also include an
organic mental disorder, a mental or behavioral disorder caused by
psychoactive substance use, a schizophrenia, schizotypal, or
delusional disorder, a mood (affective) disorder, neurotic,
stress-related, or somatoform disorder, a behavioral syndrome, an
adult personality or behavior disorder, a psychological development
disorder, or a child onset behavioral or emotional disorders.
[0023] Depressive disorders affect over fifteen percent (15%) of
the population. Depression is a mental state of depressed mood
characterized by feelings of sadness, despair, and discouragement.
Depression includes the normal feelings of "the blues" through
dysthymic disorder to major depressive disorder. Dysthymic disorder
is a mood disorder characterized by depressed feeling (sad, blue,
low), loss of interest or pleasure in usual activities, and at
least some of the following: changes in appetite and sleep
patterns, lack of energy, low self-esteem, poor concentration or
decision-making skills, and feelings of hopelessness. In dysthymic
disorders, symptoms have persisted for more than two years but are
not severe enough to meet the criteria for major depressive
disorder. Major depressive disorder is characterized by major
depressive episodes, a period of daily depressed mood or loss of
interest or pleasure in almost all activities with some combination
of the following symptoms: altered appetite, weight, or sleep
patterns, psychomotor agitation or retardation, diminished capacity
for thinking, concentration, or decisiveness, lack of energy and
fatigue, feelings of worthlessness, self-reproach, or guilt,
frequent thoughts of death or suicide, plans or attempts to commit
the latter (Diagnostic and Statistical Manual of Mental Disorders,
4th ed., American Psychiatric Association, Washington D.C.,
1994).
[0024] As used herein, the term "behavioral disorder" relates to a
disorder characterized by displayed behaviors over a long period of
time which significantly deviate from socially acceptable norms for
a person's age and situation. Exemplary behavioral disorders
include, but are not limited to, anxiety disorders (including
post-traumatic stress disorder (PTSD), obsessive-compulsive
disorder (OCD), generalized anxiety disorder, and panic disorder),
disruptive disorders, dissociative disorders, emotional disorders,
pervasive developmental disorders and substance abuse. In some
embodiments, the behavior disorder includes, or is caused by, a
mental disorder or a behavioral disorder.
[0025] As used herein, the term "mental competency" relates to the
ability of a subject to act in the circumstances, including the
ability to perform a task, job or occupation, or to reason or make
decisions. A subject's mental competency can be assessed by the
present method and system to determine, for example, whether the
subject should be allowed to purchase a firearm, or whether the
subject can perform a job function, such as a pilot. Accordingly, a
system of the present application can be made available at point of
service locations including, but not limited to, retail
establishments, medical facilities or offices, or employment
agencies/offices.
[0026] As used herein, the term "assessment" relates to
determination of the mental state of a subject, determination of
changes in the mental state of a subject, determination/diagnosis
of a mental illness in a subject or determination/diagnosis of
changes in a mental illness in a subject.
[0027] As used herein, the term "long-form answer" relates to an
answer to a question that is more than a single word answer such
as, yes, no, maybe, true or false.
[0028] As used herein, the term "subject" relates to a human
individual or subject in need of analysis of a mental state for
mental competency or diagnostic purposes.
[0029] As used herein, the terms "health professional" or
"healthcare provider" relate to an individual who provides
preventive, curative, promotional or rehabilitative health care
services in a systematic way to people, families or communities.
Health professionals include, but are not limited to, physicians,
psychiatrists, psychologists, pharmacists, physician assistants,
nurses, nurse practitioners, advanced practice registered nurses,
surgeons, surgeon's assistant, therapists, chiropractors, clinical
officers, social workers, operating department practitioners, and a
wide variety of other human resources trained to provide some type
of health care service.
[0030] As used herein, the terms "physician" or "medical doctor"
relate to a professional who practices medicine, and is concerned
with promoting, maintaining, or restoring health through the study,
diagnosis, and treatment of disease, injury, and other physical and
mental impairments. A physician may include, but is not limited to,
a primary care physician of a subject; a staff physician in a
hospital, nursing home, clinic or other medical care facility; a
physician who is a member of a medical group; a general
practitioner; a Doctor of Osteopathic Medicine or a family
physician. In some embodiments, the term "physician" does not
include a psychiatrist or a psychologist.
[0031] As used herein, the term "mental health professional"
relates to a health care practitioner or community services
provider who offers services for the purpose of improving an
individual's mental health or to treat mental illness. A mental
health professional includes, but is not limited to, a psychiatrist
and a psychologist.
Method for Assessment of a Mental State of a Human Subject
[0032] One aspect of the present application relates to a method
for assessment of a mental state of a human subject. The method
comprises the steps of: prompting the subject with at least one
question on a display of a system for assessment of the mental
state of the subject; recording at least one response to the at
least one question in the system; calculating an assessment score
based on the at least one response; determining by at least one
health professional, based on the at least one response and/or the
assessment score, the mental state of the subject; and
incorporating the mental state of the subject into an electronic
health record associated with the subject, wherein the at least one
response comprises a long-form answer and wherein the system
comprises the display, an input device, a processer, a database and
a matrix for converting the at least one response to an assessment
score.
[0033] In some embodiments, the method further comprises the step
of retrieving a medical history of the subject from a database and
accepting the at least one attribute from the medical history for
the determination of the mental state of the subject. In some
embodiments, the method further comprises the step of presenting
one or more questions about the medical history of the subject and
receiving responses to the one or more questions about the medical
history of the subject for the determination of the mental state of
the subject.
[0034] In some embodiments, the at least one attribute from the
medical history and/or the at least one response to the one or more
questions about the medical history triggers an automatic alert for
review by the at least one health professional if the at least one
attribute from the medical history and/or the at least one response
to the one or more questions about the medical history matches an
alert event in an alert database.
[0035] In some embodiments, the method comprises analyzing the at
least one response by two health professionals. In some further
embodiments, the at least one health professional is a mental
health professional. In some still further embodiments, the mental
health professional is a psychiatrist. In other further
embodiments, the at least one health professional is a physician.
In some yet further embodiments, the two health professionals are a
physician and a mental health professional.
[0036] In some embodiments, the assessment of a mental state
includes the determination or diagnosis of a mental illness or a
behavioral disorder.
[0037] In some embodiments, the mental illness or a behavioral
disorder is caused or related to a disorder of the central nervous
system. As used herein, the terms "disorder of the central nervous
system", "central nervous system disorder", "CNS disorder", and the
like refer to a disorder affecting either the spinal cord (e.g., a
myelopathy) or brain (e.g., an encephalopathy) of a subject, which
commonly presents with neurological and/or psychiatric symptoms.
CNS disorders include many neurodegenerative diseases (e.g.,
Huntington's disease, Amyotrophic lateral sclerosis (ALS),
hereditary spastic hemiplegia, primary lateral sclerosis, spinal
muscular atrophy, Kennedy's disease, Alzheimer's disease, ataxias,
Huntington's disease, Lewy body disease, a polyglutamine repeat
disease, and Parkinson's disease) and behavioral disorders (e.g.,
mood disorders, schizophrenias, and autism). Non-limiting examples
of ataxia include Friedreich's ataxia and the spinocerebellar
ataxias. Specifically for this application, CNS disorders do not
include disorders resulting from acute viral and bacterial
infections.
[0038] Non-limiting examples of CNS disorders include
neurodegenerative disorders of the central nervous system, systemic
atrophies primarily affecting the central nervous system,
extrapyramidal and movement disorders, demyelinating disorders of
the central nervous system, episodic or paroxysmal disorders of the
central nervous system, paralytic syndromes of the central nervous
system, nerve, nerve root, or plexus disorders of the central
nervous system, organic mental disorders, mental or behavioral
disorders caused by psychoactive substance use, schizophrenic,
schizotypal, or delusional disorders, mood (affective) disorders,
neurotic, stress-related, or somatoform disorders, behavioral
syndromes, adult personality or behavior disorders, psychological
development disorders, and child onset behavioral or emotional
disorders. (Diagnostic and Statistical Manual of Mental Disorders,
5th Edition (DSM-5, 2013); The World Health Organization, The
International Classification of Diseases, 10th revision (ICD-10),
Chapter V.
[0039] In some embodiments, the mental illness or behavioral
disorder is caused by neurodegenerative CNS disorders.
Neurodegenerative CNS disorders are typically characterized by
progressive dysfunction and/or cell death in the central nervous
system. The hallmark of many neurodegenerative CNS disorders is the
accumulation of misfolded proteins, such as beta-amyloid, tau,
alpha-synuclein, and TDP-43, both intracellularly and
extracellularly. Many neurodegenerative diseases are also
associated with gross mitochondrial dysfunction. Common examples of
neurodegenerative CNS disorders include Alzheimer's disease (AD),
Parkinson's disease (PD), Huntington's disease, and Amyotrophic
lateral sclerosis (ALS), a circumscribed brain atrophy (e.g.,
Pick's disease); senile degeneration of brain; a degeneration of
nervous system due to alcohol; grey-matter degeneration (e.g.,
Alpers' disease); Lewy body dementia, subacute necrotizing
encephalopathy (e.g., Leigh's disease); and subacute combined
degeneration of spinal cord.
[0040] In some embodiments, the mental illness or behavioral
disorder is caused by CNS disorders selected from the group
consisting of a systemic atrophy primarily affecting the central
nervous system, an extrapyramidal and movement disorder, a
neurodegenerative disorder of the central nervous system, a
demyelinating disorder of the central nervous system, an episodic
or paroxysmal disorder of the central nervous system, a paralytic
syndrome of the central nervous system, a nerve, nerve root, or
plexus disorder of the central nervous system.
[0041] Non-limiting examples of systemic atrophies that primarily
affect the central nervous system include: Huntington's disease;
hereditary ataxias (e.g., congenital non-progressive ataxia,
early-onset cerebellar ataxias--such as early-onset cerebellar
ataxia with essential tremor, Hunt's ataxia, early-onset cerebellar
ataxia with retained tendon reflexes, Friedreich's ataxia, and
X-linked recessive spinocerebellar ataxia--late-onset cerebellar
ataxia, ataxia telangiectasia (Louis-Bar syndrome), or hereditary
spastic paraplegia); a spinal muscular atrophy or related disorder
thereof (e.g., Werdnig-Hoffman disease (Type 1), progressive bulbar
palsy of childhood (Fazio-Londe syndrome), Kugelberg-Welander
disease (Type 3), or a motor neuron disease--such as familial motor
neuron disease, amyotrophic lateral sclerosis (ALS), primary
lateral sclerosis, progressive bulbar palsy, and progressive spinal
muscular atrophy); paraneoplastic neuromyopathy and neuropathy;
systemic atrophy primarily affecting the central nervous system in
neoplastic disease; paraneoplastic limbic encephalopathy; and
systemic atrophy primarily affecting the central nervous system in
myxedema.
[0042] In some embodiments, the mental illnesses or behavioral
disorders are caused by the CNS disorder selected from the group
consisting of Alzheimer's disease, Parkinson's disease, multiple
sclerosis, amyotrophic lateral sclerosis (ALS), Huntington's
disease, cerebral palsy, bipolar disorder, schizophrenia, Pediatric
Autoimmune Neuropsychiatric Disorders Associated with Streptococcal
infections (PANDAS), or Pediatric acute-onset neuropyschiatric
syndrome (PANS).
[0043] In some embodiments, the mental illness or behavioral
disorder is caused by an extrapyramidal and movement disorder.
Non-limiting examples of extrapyramidal and movement disorders that
affect the central nervous system include: Parkinson's disease; a
secondary parkinsonism (e.g., malignant neuroleptic syndrome or
postencephalitic parkinsonism); a degenerative disease of the basal
ganglia (e.g., Hallervorden-Spatz disease, progressive supranuclear
ophthalmoplegia (Steele-Richardson-Olszewski disease), or
striatonigral degeneration), a dystonia (e.g., drug-induced
dystonia, idiopathic familial dystonia, idiopathic non-familial
dystonia, spasmodic torticollis, idiopathic orofacial
dystonia--such as orofacial dyskinesia--or blepharospasm); an
essential tremor; a drug-induced tremor, myoclonus, drug-induced
chorea, drug-induced tics; restless legs syndrome; and stiff-man
syndrome.
[0044] In some embodiments, the mental illness is dementia. In
certain embodiments, the dementia is a cortical dementia
(associated, for example, with Alzheimer's) arising from a disorder
affecting the cerebral cortex. In certain embodiments, the dementia
is a subcortical dementia (associated, for example, with
Parkinson's disease and Huntington's disease) resulting from
dysfunction in the parts of the brain that are beneath the cortex.
In certain embodiments, the dementia is a side effect of drug
administration. In specific embodiments, the dementia is a side
effect of the administration of a chemotherapeutic agent. In
specific embodiments, the dementia is a result of undergoing
cardiac bypass. In specific embodiments, the dementia is a result
of a vascular disorder (e.g., myocardial infarction, stroke, high
blood pressure). In specific embodiments, the dementia is a result
of depression.
[0045] In some embodiments, the mental illness or behavioral
disorder is caused by a demyelinating disorder of the central
nervous system. Non-limiting examples of demyelinating disorders
that affect the central nervous system include: multiple sclerosis;
an acute disseminated demyelination disorder (e.g., neuromyelitis
optica (Devic's syndrome) or acute and subacute hemorrhagic
leukoencephalitis (Hurst's disease)); diffuse sclerosis; central
demyelination of corpus callosum; central pontine myelinolysis;
acute transverse myelitis in demyelinating disease of central
nervous system; subacute necrotizing myelitis; and concentric
sclerosis (Balo disease).
[0046] In some embodiments, the mental illness or behavioral
disorder is caused by an episodic or paroxysmal disorder of the
central nervous system. Non-limiting examples of episodic and
paroxysmal disorders that affect the central nervous system
include: epilepsy (e.g., localization-related (focal)(partial)
idiopathic epilepsy and epileptic syndromes with seizures of
localized onset, localization-related (focal)(partial) symptomatic
epilepsy and epileptic syndromes with simple partial seizures;
localization-related (focal)(partial) symptomatic epilepsy and
epileptic syndromes with complex partial seizures; a benign
epileptic syndrome--such as myoclonic epilepsy in infancy and
neonatal convulsions (familial)--childhood absence epilepsy (e.g.,
pyknolepsy), epilepsy with grand mal seizures on awakening, a
juvenile epilepsy--such as absence epilepsy or myoclonic epilepsy
(impulsive petit mal)--a nonspecific epileptic seizure--such as an
atonic, clonic, myoclonic, tonic, or tonic-clonic epileptic
seizure, epilepsy with myoclonic absences or myoclonic-astatic
seizures, infantile spasms, Lennox-Gastaut syndrome, Salaam
attacks, symptomatic early myoclonic encephalopathy, West's
syndrome, epilepsia partialis continua (Kozhevnikov epilepsy),
grand mal seizures, or petit mal); headaches (e.g., a
migraine--such as a migraine without aura (common migraine), a
migraine with aura (classical migraine), status migrainosus, and
complicated migraine--cluster headache syndrome, a vascular
headache, a tension-type headache, a chronic post-traumatic
headache, or a drug-induced headache); a cerebrovascular episodic
or paroxysmal disorder (e.g., a transient cerebral ischaemic
attacks or related syndrome--such as vertebrobasilar artery
syndrome, carotid artery syndrome (hemispheric), a multiple and
bilateral precerebral artery syndrome, amaurosis fugax, and
transient global amnesia--a vascular syndrome of the brain--such as
middle cerebral artery syndrome, anterior cerebral artery syndrome,
posterior cerebral artery syndrome, a brain stem stroke syndrome
(e.g., Benedikt syndrome, Claude syndrome, Foville syndrome,
Millard-Gubler syndrome, Wallenberg syndrome, or Weber syndrome),
cerebellar stroke syndrome, pure motor lacunar syndrome, pure
sensory lacunar syndrome, or a lacunar syndromes); and a sleep
disorder (e.g., insomnia, hyperinsomnia, a disruption in circadian
rhythm, sleep apnea, narcolepsy, or cataplexy).
[0047] In some embodiments, the mental illness or behavioral
disorder is caused by a CNS disorder is a paralytic syndrome of the
central nervous system. Non-limiting examples of paralytic
syndromes that affect the central nervous system include: a
cerebral palsy (e.g., spastic quadriplegic cerebral palsy, spastic
diplegic cerebral palsy, spastic hemiplegic cerebral palsy,
dyskinetic cerebral palsy, or ataxic cerebral palsy); a hemiplegia
(e.g., flaccid hemiplegia or spastic hemiplegia); a paraplegia or
tetraplegia (e.g., flaccid paraplegia, spastic paraplegia,
paralysis of both lower limbs, lower paraplegia, flaccid
tetraplegia, spastic tetraplegia, or quadriplegia); diplegia of
upper limbs; monoplegia of a lower limb, monoplegia of an upper
limb; cauda equina syndrome; and Todd's paralysis
(postepileptic).
[0048] In some embodiments, the mental illness or behavioral
disorder is caused by an otherwise classified disorder of the
central nervous system. Non-limiting examples of these disorders
include: hydrocephalus; a toxic encephalopathy, a cerebral cyst;
anoxic brain damage; benign intracranial hypertension; postviral
fatigue syndrome; an encephalopathy; compression of brain; cerebral
oedema; Reye's syndrome; postradiation encephalopathy; traumatic
brain injury; syringomyelia; syringobulbia; a vascular myelopathy;
spinal cord compression; myelopathy; a cerebrospinal fluid leak; a
disorder of the meninges (e.g., cerebral or spinal meningeal
adhesion); and a post-procedural disorder of nervous system (e.g.,
cerebrospinal fluid leak from spinal puncture, an adverse reaction
to a spinal or lumbar puncture, or intracranial hypotension
following ventricular shunting).
[0049] In some embodiments, the mental illness is an organic mental
disorder. Non-limiting examples of organic mental disorders that
affect the central nervous system include: dementia (e.g., dementia
associated with Alzheimer's disease, Pick's disease,
Creutzfeldt-Jakob disease, Huntington's disease, Parkinson's
disease, or human immunodeficiency virus (HIV) disease, or vascular
dementia--such as multi-infarct dementia); organic amnesic syndrome
not induced by alcohol and other psychoactive substances); delirium
not induced by alcohol and other psychoactive substances; a mental
disorder due to brain damage and dysfunction and to physical
disease (e.g., organic hallucinosis, organic catatonic disorder,
organic delusional (schizophrenia-like) disorder, organic mood
(affective) disorder, organic anxiety disorder, organic
dissociative disorder; organic emotionally labile (asthenic)
disorder; a mild cognitive disorder, or organic brain syndrome);
and a personality and behavioral disorders due to brain disease,
damage and dysfunction (e.g., organic personality disorder,
postencephalitic syndrome, or postconcussional syndrome).
[0050] In some embodiments, the mental illness or behavioral
disorder is a mental or behavioral disorder caused by psychoactive
substance use. Non-limiting examples of mental or behavioral
disorders caused by psychoactive substance use that affect the
central nervous system include: acute intoxication (e.g., from
alcohol, opioid, cannabis, benzodiazepine, or cocaine use); a
dependence syndrome (e.g., from alcohol, opioid, cannabis,
benzodiazepine, cocaine, or nicotine addiction); a withdrawal
syndrome (e.g., an alcohol or benzodiazepine withdrawal syndrome);
delirium tremens; and a psychotic disorder (e.g., alcoholic
hallucinosis or stimulant psychosis); an amnesic syndrome (e.g.,
Korsakoff s syndrome); a residual and late-onset psychotic disorder
(e.g., posthallucinogen perception disorder).
[0051] In some embodiments, the mental illness or behavioral
disorder is an autism spectrum disorder. In certain embodiments,
the CNS disorder is autism, Asperger syndrome, pervasive
developmental disorder not otherwise specified (PDD-NOS), childhood
disintegrative disorder, or Rett syndrome.
[0052] In some embodiments, the mental illness or behavioral
disorder is a schizophrenia, schizotypal, or delusional disorder.
Non-limiting examples of schizophrenia, schizotypal, and delusional
disorders that affect the central nervous system include:
schizophrenia (e.g., paranoid schizophrenia, hebephrenic
schizophrenia (disorganized schizophrenia), catatonic
schizophrenia, undifferentiated schizophrenia, post-schizophrenic
depression, residual schizophrenia, simple schizophrenia,
cenesthopathic schizophrenia, schizophreniform disorder, or
schizophreniform psychosis); schizotypal disorder; a persistent
delusional disorder (e.g., delusional disorder, delusional
dysmorphophobia, involutional paranoid state, or paranoia
querulans); an acute or transient psychotic disorder (e.g., acute
polymorphic psychotic disorder without symptoms of schizophrenia,
acute polymorphic psychotic disorder with symptoms of
schizophrenia, or acute schizophrenia-like psychotic disorder); an
induced delusional disorder (e.g., folie a deux, induced paranoid
disorder, or induced psychotic disorder); a schizoaffective
disorder (e.g., manic type, depressive type, or mixed type
schizoaffective disorder); and chronic hallucinatory psychosis.
[0053] In some embodiments, the mental illness or behavioral
disorder is a mood (affective) disorder. Non-limiting examples of
mood (affective) disorders that affect the central nervous system
include: a manic episode (e.g., hypomania, mania without psychotic
symptoms, or mania with psychotic symptoms); a bipolar affective
disorder (e.g., bipolar affective disorder--current episode
hypomanic, bipolar affective disorder--current episode manic
without psychotic symptoms, bipolar affective disorder--current
episode manic with psychotic symptoms, bipolar affective
disorder--current episode mild or moderate depression, bipolar
affective disorder--current episode severe depression without
psychotic symptoms, bipolar affective disorder--current episode
severe depression with psychotic symptoms, bipolar affective
disorder--current episode mixed, bipolar affective
disorder--currently in remission, bipolar II disorder, or recurrent
manic episodes); a depressive episode (e.g., mild depressive
episode, moderate depressive episode, severe depressive episode
without psychotic symptoms, severe depressive episode with
psychotic symptoms, atypical depression, or single episodes of
"masked" depression); a recurrent depressive disorder (e.g.,
recurrent depressive disorder--current episode mild, recurrent
depressive disorder--current episode moderate, recurrent depressive
disorder--current episode severe without psychotic symptoms,
recurrent depressive disorder--current episode severe with
psychotic symptoms, or recurrent depressive disorder--currently in
remission); a persistent mood (affective) disorder (e.g.,
cyclothymia or dysthymia); mixed affective episode; and recurrent
brief depressive episodes.
[0054] In some embodiments, the mental illness or behavioral
disorder is a neurotic, stress-related, or somatoform disorder.
Non-limiting examples of neurotic, stress-related, or somatoform
disorders that affect the central nervous system include: a phobic
anxiety disorder (e.g., agoraphobia, anthropophobia, social
neurosis, acrophobia, animal phobias, claustrophobia, or simple
phobia); an otherwise categorized anxiety disorder (e.g., panic
disorder (episodic paroxysmal anxiety) or generalized anxiety
disorder); obsessive-compulsive disorder; an adjustment disorder
(e.g., acute stress reaction; post-traumatic stress disorder, or
adjustment disorder); a dissociative (conversion) disorder (e.g.,
dissociative amnesia, dissociative fugue, dissociative stupor;
trance disorder, possession disorder, dissociative motor disorder,
dissociative convulsions, dissociative anaesthesia and sensory
loss, mixed dissociative (conversion) disorder, Ganser's syndrome,
or multiple personality disorder); a somatoform disorder (e.g.,
Briquet's disorder, multiple psychosomatic disorder, a
hypochondriacal disorder--such as body dysmorphic disorder,
dysmorphophobia (nondelusional), hypochondriacal neurosis,
hypochondriasis, and nosophobia--a somatoform autonomic
dysfunction--such as cardiac neurosis, Da Costa's syndrome, gastric
neurosis, and neurocirculatory asthenia--or psychalgia);
neurasthenia; depersonalization-derealization syndrome; Dhat
syndrome, occupational neurosis (e.g., writer's cramp);
psychasthenia; psychasthenic neurosis; and psychogenic syncope.
[0055] In some embodiments, the mental illness or behavioral
disorder is a behavioral syndrome associated with physiological
disturbances or physical factors. Non-limiting examples of
behavioral syndromes associated with physiological disturbances or
physical factors that affect the central nervous system include: an
eating disorder (e.g., anorexia nervos, atypical anorexia nervosa,
bulimia nervosa, atypical bulimia nervosa, overeating associated
with other psychological disturbances, vomiting associated with
other psychological disturbances, or pica in adults); a nonorganic
sleep disorder (e.g., nonorganic insomnia, nonorganic hypersomnia,
nonorganic disorder of the sleep-wake schedule, sleepwalking
(somnambulism), sleep terrors (night terrors), or nightmares); a
sexual dysfunction not caused by organic disorder or disease; a
mental or behavioral disorder associated with the puerperium (e.g.,
postnatal depression, postpartum depression, or puerperal
psychosis); and abuse of non-dependence-producing substances.
[0056] In some embodiments, the mental illness or behavioral
disorder is an adult personality or behavior disorder. Non-limiting
examples of adult personality and behavior disorders that affect
the central nervous system include: a specific personality disorder
(e.g., paranoid personality disorder, schizoid personality
disorder, a dissocial personality disorder--such as antisocial
personality disorder--an emotionally unstable personality
disorder--such as borderline personality disorder--histrionic
personality disorder, an anankastic personality disorder--such as
obsessive-compulsive personality disorder, anxious (avoidant)
personality disorder, dependent personality disorder, eccentric
personality disorder, haltlose personality disorder, immature
personality disorder, narcissistic personality disorder,
passive-aggressive personality disorder, or psychoneurotic
personality disorder); mixed personality disorder; a habit or
impulse disorder (e.g., pathological gambling, pathological
fire-setting (pyromania), pathological stealing (kleptomania), or
trichotillomania); and Munchausen syndrome.
[0057] In some embodiments, the mental illness or behavioral
disorder is a psychological development disorder. Non-limiting
examples of psychological development disorders that affect the
central nervous system include: a developmental disorder of speech
or language (e.g., specific speech articulation disorder,
expressive language disorder, receptive language disorder
(receptive aphasia), acquired aphasia with epilepsy
(Landau-Kleffner disorder), or lisping); a developmental disorder
of scholastic skills (e.g., a specific reading disorder--such as
developmental dyslexia--specific spelling disorder, a specific
disorder of arithmetical skills--such as developmental acalculia
and Gerstmann syndrome--or a mixed disorder of scholastic skills);
a developmental disorder of motor function (e.g., developmental
dyspraxia); a mixed specific developmental disorder; and a
pervasive developmental disorder (e.g., childhood autism, atypical
autism, Rett's syndrome, overactive disorder associated with mental
retardation and stereotyped movements, or Asperger's syndrome).
[0058] In some embodiments, the mental illness or behavioral
disorder is a behavioral or emotional disorder with onset usually
occurring in childhood and adolescence. Non-limiting examples of
behavioral or emotional disorders with onset usually occurring in
childhood and adolescence that affect the central nervous system
include: a hyperkinetic disorder (e.g., a disturbance of activity
and attention--such as attention-deficit hyperactivity disorder and
attention deficit syndrome with hyperactivity--or hyperkinetic
conduct disorder); a conduct disorder (e.g., conduct disorder
confined to the family context, unsocialized conduct disorder,
socialized conduct disorder, or oppositional defiant disorder); a
mixed disorder of conduct or emotions (e.g., depressive conduct
disorder); an emotional disorder with onset specific to childhood
(e.g., separation anxiety disorder of childhood, phobic anxiety
disorder of childhood, social anxiety disorder of childhood,
sibling rivalry disorder, identity disorder, or overanxious
disorder); a disorder of social functioning with onset specific to
childhood and adolescence (e.g., elective mutism, reactive
attachment disorder of childhood, or disinhibited attachment
disorder of childhood); a tic disorder (e.g., transient tic
disorder, chronic motor or vocal tic disorder, or combined vocal
and multiple motor tic disorder (de la Tourette)); and an otherwise
classified behavioral or emotional disorder with onset usually
occurring in childhood and adolescence (e.g., nonorganic enuresis,
nonorganic encopresis, feeding disorder of infancy and childhood,
pica of infancy and childhood, stereotyped movement disorders,
stuttering (stammering), cluttering, attention deficit disorder
without hyperactivity, Pediatric Autoimmune Neuropsychiatric
Disorders Associated with Streptococcal infections (PANDAS), or
Pediatric acute-onset neuropyschiatric syndrome (PANS)).
[0059] In some embodiments, the at least one response prompts the
system to present at least one additional question related to the
at least one response. In related embodiments, the at least one
response prompts the system to present at least one set of
additional questions related to the at least one response. In some
further embodiments, a set of additional questions comprises at
least 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18,
19 or 20 questions.
[0060] In other embodiments, the at least one response or responses
of the subject to the at least one additional question or to the at
least one set of additional questions prompts the system to present
at least one additional question related to a different facet of
the mental health of the subject. In related embodiments, the at
least one response or responses of the subject to the at least one
additional question or to the at least one set of additional
questions prompts the system to present at least one set of
additional questions related to a different facet of the mental
health of the subject. In some further embodiments, a set of
additional questions comprises at least 2, 3, 4, 5, 6, 7, 8, 9, 10,
11, 12, 13, 14, 15, 16, 17, 18, 19 or 20 questions. In other
related embodiments, the system present the subject with questions
or sets of questions related to at least 2, 3, 4, 5, 6, 7, 8, 9,
10, 11, 12, 13, 14, 15, 16, 17, 18, 19 or 20 facets of mental
health.
[0061] In some embodiments, the method comprises analyzing the at
least one response by two health professionals. In some further
embodiments, the at least one health professional is a mental
health professional. In some still further embodiments, the mental
health professional is a psychiatrist. In other further
embodiments, the at least one health professional is a physician,
who is in some embodiments the primary care physician of the
subject. In some yet further embodiments, the two health
professionals are a physician and a mental health professional.
[0062] In some embodiments, the method further comprises the step
of retrieving a medical history of the subject from a database and
accepting the at least one attribute from the medical history for
the determination of the mental state of the subject. In some
embodiments, the method further comprises the step of presenting
one or more questions about the medical history of the subject and
receiving responses to the one or more questions about the medical
history of the subject for the determination of the mental state or
behavioral disorder of the subject.
[0063] Attributes from the medical history include a list of
previous illnesses, symptoms, medicines, treatments, health risk
factors, operations, and/or doctor visits for the subject. In some
embodiments, the medical history includes life history and/or
social history characteristics such as smoking, drinking, drug use,
sexual history, exercise history, eating history, nutraceutical
history, or the like. In some embodiments, the medical history
includes a family medical history. A family medical history may
include a list of previous illnesses, symptoms, medicines,
treatments, health risk factors, operations, and/or doctor visits
associated with family members related to the subject.
[0064] In some embodiments, the at least one attribute includes
mental attributes of the subject. A mental attribute may include an
attribute that may be related to and/or associated with basic
mental function and/or high-level brain function. Some examples of
a mental attribute may include an indication of learning
disability, cognitive disability, measurements of brain activity,
for example using functional MRI or near infra-red technology,
and/or measurements of mental development.
[0065] In some embodiments, the at least one attribute includes
descriptions of mental symptoms of the subject. A mental symptom
may include a manifestation, sign, and/or an indication of the
presence of a disease and/or some other mental disorder and/or
abnormality. Some examples of a mental symptom may include lack of
attention, indication of stress, hyperactivity, nervousness, and/or
lack of responsiveness.
[0066] In some embodiments, the at least one attribute includes
indication of anxiety, an appearance, a behavior, depression, fear,
inattention, a mood disturbance, a phobia, or a psychological test
result. Anxiety may include feelings of fear, apprehension, and/or
worry and may be accompanied by physical sensations. An appearance
may include an outward, audible, and/or visible aspect of a person
and/or thing associated with a person. A behavior may include the
manner in which a person and/or thing associated with a person acts
and/or reacts. Depression may include a mental state characterized
by pessimism, a sense of inadequacy, despondence, despair, a low
level of energy, and/or a lack of activity. Fear may be caused by
impending danger, perceived evil, and/or pain, whether real or
imagined. Inattention may include the failure of a person to focus
attention. A mood disturbance may include a change in emotional
state. A phobia may include an irrational, and/or persistent fear
of certain situations, objects, activities, and/or people. A
psychological test result may include a sample behavior for
inferring a certain generalization about a person. For example, a
personality test result may indicate that person has
obsessive/compulsive characteristics. In some instances, mental
indication accepter module 636 may include a computer
processor.
[0067] In some embodiments, the at least one attribute includes at
least one measurement associated with at least one of brain
activity, cardiac activity, vascular activity, peripheral neural
signals, hemodynamic activity, or metabolic activity. Brain
activity may include the electrical activity of the brain, such as
that measured by EEG, MEG, or the like. Other brain activity
measurements may include functional MM imaging, near infra-red
imaging, PET scanning, or the like. Cardiac activity may include
electrical activity in the heart, such as that measured by EKG or
visual imaging. Vascular activity may include any activity and/or
function of the circulatory system. Peripheral neural signals may
include neural signals sent through the peripheral nervous system.
Hemodynamic activity may include any activity associated with the
circulatory system. Metabolic activity may include any activity
associated with the biochemical reactions occurring in a living
organism. In some instances, mental activity accepter module 638
may include a computer processor.
[0068] In some embodiments, the at least one attribute includes
measurement of at least one brain activity surrogate marker. Brain
activity surrogate markers may include indicators of attention,
approval, disapproval, recognition, cognition, memory, trust, or
the like in response to a stimulus, other than measurement of brain
activity associated with the stimulus. Some examples of surrogate
markers may include a skin response to a stimulus; a face pattern
indicative of approval, disapproval, or emotional state; eye
movements or pupil movements indicating visual attention to an
object; voice stress patterns indicative of a mental state, or the
like. Surrogate markers may be used in conjunction with brain
activity measurements for higher confidence in a predictive or
interpretational outcome. For example, brain activation of the
caudate nucleus in combination with calm voice patterns may
increase confidence in a predictor of trust between a subject and a
stimulus. Additional discussion regarding surrogate markers may be
found in Cohn, J. N., Introduction to Surrogate Markers,
CIRCULATION 109: IV20-21, American Heart Association, (2004), which
is incorporated herein by reference.
[0069] In some embodiments, the at least one attribute includes
measurement of iris dilation or constriction, gaze tracking, skin
response, or voice response. In some embodiments, the medical
history includes measurement of changes in the movement of an
individual's iris (with corresponding changes in the size of the
pupil) before, during, and/or after administration of a bioactive
agent and/or an artificial sensory experience. Such measurements of
physiologic activity that indicate brain activity and/or mental
state may be carried out at a time that is proximate to
administration of a bioactive agent and/or an artificial sensory
experience.
[0070] In some embodiments, the at least one attribute includes
measurement of skin response of the subject. Brain activity may be
determined by detection of a skin response associated with a
stimulus. One skin response that may correlate with mental state
and/or brain activity is galvanic skin response (GSR), also known
as electrodermal response (EDR), psychogalvanic reflex (PGR), or
skin conductance response (SCR). This is a change in the electrical
resistance of the skin. There is a relationship between sympathetic
nerve activity and emotional arousal, although one may not be able
to identify the specific emotion being elicited. The GSR is highly
sensitive to emotions in some people. Fear, anger, startle
response, orienting response, and sexual feelings are all among the
emotions which may produce similar GSR responses. GSR is typically
measured using electrodes to measure skin electrical signals. For
example, an Ultimate Game study measured skin-conductance responses
as a surrogate marker or autonomic index for affective state, and
found higher skin conductance activity for unfair offers, and as
with insular activation in the brain, this measure discriminated
between acceptances and rejections of these offers. See Sanfey,
"Social Decision-Making: Insights from Game Theory and
Neuroscience," Science, vol. 318, pp. 598-601 (26 Oct. 2007), which
is incorporated herein by reference. Other skin responses may
include flushing, blushing, goose bumps, sweating, or the like.
[0071] In some embodiments, the at least one attribute includes
measurement of voice response. Voice response may include speech
captured by a microphone during presentation of a characteristic.
Speech or voice can be measured, for example, by examining voice,
song, and/or other vocal utterances of a subject before, during,
and/or after administration of a bioactive agent and/or an
artificial sensory experience to an individual. Such measurements
may include, for example, as discussed above, layered voice
analysis, voice stress analysis, or the like.
[0072] In some embodiments, the at least one attribute includes
personal identification data, physical characteristics data, health
profile data, family health history data, drug and vitamin/mineral
supplement data, health baseline data, diet and nutritional data,
environmental exposure data, and behavioral data.
[0073] The personal identification data comprises essential
personal information that facilitates the identification of an
individual and the establishment of core demographic
characteristics. For example, the personal identification data
includes name, address, residence history, age, gender, race,
ethnicity, education, sexual preference, martial status, living
arrangements, marital history, children, occupation, work history,
home and work environments, travel history, military service
history, genealogy, relationships, recreational activities and the
like. Sensitive information, such as name and street address, may
be segregated and coded for privacy and security.
[0074] The physical characteristics data includes height, weight,
body fat ratio, body symmetry and dimensions, skin shade and
texture, eye color, hair growth/color and texture, strength
symmetry, endurance, coordination, posture, gait, nail growth and
features, feet size, physical peculiarities, physical deformities,
growths, blemishes, teeth and gums, flexibility, and the like.
These characteristics are useful in establishing the subscriber's
physical uniqueness as well as their membership in population
groups that share certain characteristics.
[0075] The health profile data comprises a broad array of
information pertaining to the subscriber's psychological and
physiological characteristics and condition, medical history data,
hazardous and toxic material exposure data, allergies data,
disabilities, reproductive history, depression data, family
(genealogy) health history data stress level data, mental condition
data, current health conditions data, physical sensitivities and
pain data, activity level and physical fitness data, illnesses
history data, history of injuries data, chronic conditions data,
visual acuity data, night vision data, hearing acuity data,
reaction time data and the like. The health profile data also
incorporates the results of quantitative tests including blood
chemistry tests, breath analysis (i.e., laser absorption
spectroscopy), medical imaging (i.e., x-rays, magnetic resonance
imaging, lithotripsy, computed tomography, fluorescence
spectroscopy, ultrasounds, thermographs, and others), photographic
imaging, and other psychological, physical, and physiological
tests.
[0076] The family health history addresses the health conditions
and unique characteristics of the subject's living and deceased
blood relatives. The family health history data is comprised of
personal description data, physical description data, physical
characteristics, demographic data, occupational data, disabilities,
behaviors, health and medical histories, and the like. The family
history data collection includes names, birthdates, place of birth,
number of children (including genders and birthdates), places of
residency, health histories, ages at death, height, weight,
physical and health peculiarities, chronic conditions,
sensitivities/allergies, disease history, cause of death, health
conditions at time of death, history of injuries, deformities,
visual acuity, hearing acuity, mental condition and acuity,
disabilities, occupations/professions, medication history
(including diagnosis, treatments, test results, evaluations, and
the like), reproductive histories, alcohol and drug usage, blood
types, and other psychological, physical, physiological and
behavioral details that would be useful in the identification of
genetic characteristics and predispositions.
[0077] The drug and vitamin/mineral supplement data comprises a
detailed history of prescription and non-prescription drugs,
vitamin supplements, herbs, and mineral supplement usages. Included
in the history may be the item description, dosage, frequency
taken, date started, reason for taking, date stopped, reason for
stopping, and observed effects, side effects, reactions, and the
like.
[0078] The health baseline data may, in part, be derived from
information compiled in previous databases including, the personal
identification data, physical characteristics data and health
profile data. Certain key psychological characteristics (i.e.,
depression, confusion, neurosis and other like mental conditions or
mental cognitive peculiarities), physical characteristics (i.e.,
height, weight, body fat ratio, posture, flexibility, mobility,
hair growth, hair color, skin color/tone, eye color and the like),
physiological characteristics (i.e., visual performance, hearing
performance, blood pressure, heart rate, repertory rate, heart
rhythm, blood chemistry, and other major organ system performance
characteristics), and medical conditions may be recorded and
updated over a period of time. The resulting database will depict
each characteristic separately and their respective performance
values.
[0079] In some cases, the data may be subject to a
patterns-analysis, which identifies repetitive fluctuations in
order to establish predictable patterns, ranges of fluctuation and
rate of change. Where possible, certain pattern fluctuations are
linked to predictable cycles, such as, time-of-day, seasons, and
biological cycles. In addition, the subscriber's physical,
psychological, physiological and behavioral characteristics
(including patterns) may be assessed relative to authoritative
standards and norms of similar population groups. The resulting
compilation of data forms a baseline or reference-point to which
new data, representing the latest health condition of the
subscriber for comparison. The comparison provides a basis for
determining whether the new data is consistent with or deviates
from the baseline. The deviations may be positive (improvements in
a condition), negative (evidence of deterioration), or they may be
evidence of a new condition or abnormality.
[0080] The diet and nutritional data (also referred to as diet and
nutritional profile) systematically records the subscriber's
dietary and nutritional intake and eating practices over time. For
example, data may be obtained by periodically requesting
information on what, how much, and when the subscriber ate and/or
drank. The requests for information may target the time period of
about 2 to about 8 hours preceding the request and the requests may
be systematically timed so that every conscious hour may be
eventually subjected to multiple requests for information. Next,
the subscriber's food intake (including drinks and snacks) may be
subjected to a comprehensive nutritional evaluation which
establishes the nutritional value of the ingested substances
including the amount and type of vitamins, minerals, calories,
protein, carbohydrates, antioxidants, sodium, fats and the like.
Each meal and snack (including drinks) is assessed and registered
in order to construct a detailed, chronological image of the
subscriber's dietary intake. This data may be subjected to
pattern-analysis in order to identify repetitive patterns and
associate fluctuations within the patterns to their influencing
factors. The resulting diet and nutritional profile may be
continuously updated in order to represent the subscriber's most
current dietary intake. As an additional feature, specific food and
drink descriptions and quantities consumed are documented and used
to identify dietary preferences and predispositions.
[0081] The environmental exposure data consists of those
environmental characteristics that describe both natural
environmental considerations (i.e., natural occurrences such as
outside air temperature, humidity, sunlight, naturally occurring
toxic/hazardous emissions, terrain, rain, water temperature, and
others), manmade or man influenced environments considerations
(i.e., air conditioning, heating, ergonomics, lighting, pollution
and contamination, traffic, and the like), and hazardous
environments (i.e., intentional and unintentional manmade or man
caused environmental considerations such as exposure to dangerous
situations and dangerous substances such as nuclear materials,
toxic or hazardous biological substances, and toxic or hazardous
chemicals, and the like).
[0082] The behavior data (also referred to as behavior profile)
documents a variety of behaviors that are known to affect wellness
and longevity. To simplify behavior assessment, and, as used
herein, "behaviors" are strictly defined as the actions taken by a
person to relax, deal with stress, and occupy free time. The
behaviors, amount of time spent in these behaviors, and the degree
or intensity in which the subscriber participates in a behavior may
be registered. The behaviors may be divided into three general
categories. The first category includes behaviors that involve
taking a substance (alcohol, tobacco, drugs, food, coffee, and the
like). The second category includes behaviors that require doing
something (jogging, watching sports, gambling, watching TV, playing
golf, conversations, sewing, and the like). The third category
addresses coping impulses which include impulsive reactions to
anger, affection, fear, confusion, and embarrassment. The data
acquired may be subjected to a pattern-analysis to identify
repetitive patterns and tendencies.
[0083] Psychological characteristics address the subscriber's
mental state and processes including emotions and behaviors. The
physiological characteristics data address the normal and abnormal
performance characteristics of the subscriber's organ systems.
These may include data such as vital signs, cardiovascular system,
respiratory system, nervous system, skin system, musculoskeletal
system, blood system, digestive system, endocrine system, urinary
system, reproductive system and combinations comprising at least
one of the foregoing for establishing unique characteristics and
performance that may include visual acuity, blood pressure, heart
rate and rhythm, respiratory rate, blood oxygen level, cholesterol
levels, estrogen level, hearing acuity and sensitivity, sensory
perception, PSA level, insulin levels, mental clarity,
responsiveness, gait, posture, balance, teeth and gum condition,
skin abnormalities, inflammation, pain, discomfort, discharges and
the like.
[0084] The medical history of the subject or the response the
subject gives to in response to the one or more questions about the
subject's medical history may be used in the determination of the
subject's mental status by virtue of the symptoms or symptoms
groups displayed by subjects. Without limiting the scope of the
present disclosure, exemplary symptoms are somatic concern,
anxiety, depressed mood, suicidality, guilt, hostility, aggression,
elated mood, grandiosity, pressure of speech,
suspiciousness/persecution, auditory or visual hallucinations,
ideas of reference or control, unusual or bizarre thought content,
thought disorder, bizarre behavior, self-neglect, self-harm,
threats to others, disorientation, conceptual disorganization,
blunted or flat affect, emotional withdrawal, apathy, social
withdrawal, social anxiety, motor retardation, tension,
uncooperativeness, excitement, inattention, distractibility, motor
hyperactivity, mannerisms or posturing, movement disorder,
delusions, poor rapport, passivity, poor abstract thinking, reduced
or absent theory of mind, reduced insight, reduced judgment,
reduced memory, anti-social traits, tendencies or acts, chronic
regional pain or other unexplained chronic pain syndrome, offending
behavior of a forensic nature, disturbance of volition, poor
impulse control, anger, delayed gratification difficulty, affective
lability, mood lability, mood swings, active social avoidance,
preoccupation, obsessional preoccupation, ruminations, disturbance
of spontaneity or flow of conversation, poor self care, anxious
worrying, tension, tonicity, grasp strength, rumination, fear,
active/intentional and passive/unintentional avoidance,
dissociation, stress, attenuated psychotic symptoms, overvalued
ideation, brief intermittent psychotic symptoms, subjective
self-disturbance, re-experiencing phenomena, sense of presence,
distancing, corporeality, disturbed stream of consciousness,
self-other boundary disturbances, self-demarcation disturbances,
body image disturbances, anorexia, orientation and re-orientation
disturbances, self-consciousness, first rank passivity symptoms,
ideas of reference or control, loss of sense of self, thought
insertion, thought broadcasting, thought blocking, thought
replacement, abnormal perception, delusional attribution or
interpretation, under-arousal, disinhibition, impulsivity,
over-aropusal, difficulty attending, reduced attention span,
scattered attention, distressing recollections, emotional
dysregulation, implausible belief, obsessional compensations,
intrusive auditory thoughts, euphoria, apathy, and
irritability.
[0085] In some embodiments, the at least one attribute includes
characteristics of certain receptors, such as serotonin receptors,
dopamine receptors, estrogen receptors and adrenergic receptors in
the subject. In some embodiments, at least one attribute includes
the one or more events, such as stroke, hypertension, diabetes,
cardiovascular diseases, kidney disorders can cancer, in the
subject's medical history.
[0086] In some embodiments, the method of determining the mental
state of a subject comprises determining the mental competency to
perform a function. In certain embodiments, the function concerns
the capacity to operate a firearm. In other embodiments, the
function comprises operating a motor vehicle. In some embodiments,
the motor vehicle is an automobile. In other embodiments, the motor
vehicle is an aircraft, boat or ship.
[0087] In some embodiments, the method comprises determining the
mental state of a subject in order to determine whether the subject
can purchase and/or possess a firearm, whether the subject
possesses the mental capacity to safely operate a firearm, whether
the subject has the mental capacity to safely own or operate a
motor vehicle, or whether the subject's responses are contrary to
other information previously supplied to other health
professionals, law enforcement professionals, probation officials,
immigration authorities or other governmental agencies.
[0088] In some embodiments, the mental state of the subject is
determined based on the assessment score. In further embodiments, a
depression severity questionnaire is presented to the subject when
the score indicates the presence of depression in the subject. In
other embodiments, the method further comprises collecting
demographic information regarding the subject. This information may
be used in the calculation of one or more of the assessment
scores.
[0089] The system may further include an alert database, which
includes information concerning a number of mental states or
behavioral disorders that can pose a danger to the subject, the
subject's family, other people, as well as property. In certain
cases, the alert may be related to a health danger such as, but not
limited to, heart attack, stroke, aneurism, or dementia. In other
cases, the alert is related to the capacity to own or operate
firearms or motor vehicles. In other cases, the alert may relate to
information contrary to information previously supplied by the
subject to government authorities or agencies.
[0090] In some embodiments, the alert database includes a matrix
for converting one or more responses to one or more questions in
the assessment to generate one of more assessment scores for
determining if the system should additionally send an automatic
alert to one or more additional health professionals, law
enforcement professionals, probation officials, motor vehicle
licensing professionals, immigration officials, or a combination
thereof. Each of assessment scores may be compared with a threshold
score for activating the alert, wherein a score exceeding the
threshold triggers activation of the alert. In some embodiments,
the alert is categorized into multiple levels e.g., level 1, level
2 and level 3 alert with level 3 alert being the most serious alert
level. In some embodiments, the alert level is color-coded, e.g.,
level blue, level orange and level red alert with level red alert
being the most serious alert level. In some embodiments, the alert
is presented in the form of an alert signal on the computer screen
for the health professionals' review. In other embodiments, the
alert level is listed as an item of an assessment report generated
by the system for review by the health professionals.
[0091] In some embodiments, the at least one attribute from the
medical history and/or the at least one response to the one or more
questions about the medical history triggers the system to present
an automatic alert for review by the at least one health
professional if the at least one attribute from the medical history
and/or the at least one response to the one or more questions about
the medical history matches an alert event in the alert
database.
[0092] Pursuant to the review by the health professional and an
analysis of other alert events in the alert database, the system
may further send an automatic alert to additional health
professionals, law enforcement professionals, probation officials,
motor vehicle licensing professionals, immigration authorities, or
a combination thereof.
[0093] In yet other embodiments, there are a plurality of
assessments; and the plurality of assessments are administered
preferentially. In some embodiments, the term "administered
preferentially" means that a subsequent assessment is administered
to the subject based upon an answer to a preceding assessment.
[0094] In even other embodiments, the system is configured on a
handheld device. In some embodiments the handheld device is a
laptop computer, tablet computer, smartphone, or PDA.
[0095] In some embodiments, the method further comprises
determining if the subject is undergoing an initial wellness
assessment or a follow-up.
[0096] The determined mental state can include any of the
above-described disorders. In certain embodiments, the determined
mental state is a behavioral disorder selected from the group
consisting of depression, substance abuse, risk for bipolar
disorder, and post-traumatic stress disorder.
System for Assessment of a Mental State of a Human Subject
[0097] Another aspect of the present application relates to a
system for assessment of a mental state of a subject. The system
includes: a computer-readable memory, the computer-readable memory
configured to store computer-executable instructions; an input
device configured to receive an input from the subject; and a
processor configured to execute the computer-executable
instructions. The computer-executable instructions include
prompting the subject with at least one question in a system for
assessment of mental state on a display; recording at least one
response to the at least one assessment, wherein the at least one
response comprises a long-form answer; converting the at least one
response into at least one assessment score; generating an output
comprising the at least one assessment score for assessment of the
mental state of the subject by at least one health professional;
retrieving a medical history of the subject from a database and
accepting at least one attribute from the medical history for the
determination of the mental state of the subject, and/or presenting
one or more questions about the medical history of the subject and
receiving at least one response to the one or more questions about
the medical history of the subject for the determination of the
mental state of the subject, wherein the at least one attribute
from the medical history and/or the at least one response to the
one or more questions about the medical history triggers the system
to present an automatic alert for review by the at least one health
professional if the at least one attribute from the medical history
and/or the at least one response to the one or more questions about
the medical history matches an alert event in an alert database;
and generating a report of the mental state of the subject based on
the assessment by the at least one health professional and
incorporating the report into an electronic health record
associated with the subject.
[0098] In some embodiments, the computer-executable instructions
further comprise: a plurality of assessments; and the plurality of
assessments is administered preferentially.
[0099] In some embodiments, the system is configured on a handheld
device.
[0100] In other embodiments, the computer-executable instructions
further comprise determining if the subject is undergoing an
initial wellness assessment or a follow-up.
[0101] In yet other embodiments, the computer-executable
instructions further comprise collecting demographic information
regarding the subject.
[0102] In certain embodiments, the diagnosed behavior disorder
includes, or is caused by, a mental disorder or a behavioral
disorder as described herein. In particular embodiments, the
diagnosed behavioral disorders include at least one of depression,
substance abuse, risk for bipolar disorder, and post-traumatic
stress disorder.
[0103] FIG. 1 is a block diagram illustrating exemplary hardware
components that may be used for implementing aspects of the system
and method for using a wellness assessment behavioral health kiosk
10. A computer system 100 may include and execute programs to
perform functions described herein, including steps of method
described above. While only one processor 114 is shown in FIG. 1,
it is understood that the computer system 100 used to implement the
wellness assessment behavioral health kiosk 10 may include multiple
processors. Additionally, a system for implementing the wellness
assessment behavioral health kiosk 10 may include multiple
networked computer systems 100. Further, a mobile device that
includes some of the same components of computer system 100 may
perform steps of the method described above. Computer system 100
may connect with a network 118, e.g., Internet, or other network,
to receive inquires, obtain data, and transmit information (e.g.,
to a user work station or other user computing device) as described
above.
[0104] Computer system 100 typically includes a memory 102, a
secondary storage device 112, and a processor 114. Computer system
100 may also include a plurality of processors 114 and be
configured as a plurality of, e.g., bladed servers, or other known
server configurations. Computer system 100 may also include an
input device 116, a display device 110, and an output device
108.
[0105] Memory 102 may include RAM or similar types of memory, and
it may store one or more applications for execution by processor
114. Secondary storage device 112 may include a hard disk drive,
floppy disk drive, CD-ROM drive, or other types of non-volatile
data storage. Processor 114 may include multiple processors or
include one or more multi-core processors. Any type of processor
114 capable of performing the calculations described herein may be
used. Processor 114 may execute the application(s) that are stored
in memory 102 or secondary storage 112, or received from the
Internet or other network 118. The processing by processor 114 may
be implemented in software, such as software modules, for execution
by computers or other machines. These applications preferably
include instructions executable to perform the functions and
methods described above and illustrated in the Figures herein. The
applications may provide graphic user interfaces (GUIs) through
which users may view and interact with the application(s).
[0106] Also, as noted, processor 114 may execute one or more
software applications in order to provide the functions described
in this specification, specifically to execute and perform the
steps and functions in the methods described above. Such methods
and the processing may be implemented in software, such as software
modules, for execution by computers or other machines.
[0107] Input device 116 may include any device for entering
information into computer system 100, such as a touch-screen,
keyboard, mouse, cursor-control device, microphone, digital camera,
video recorder or camcorder. Input device 116 may be used to enter
information into GUIs during performance of the methods described
above. Display device 110 may include any type of device for
presenting visual information such as, for example, a computer
monitor or flat-screen display (or mobile device screen). Output
device 108 may include any type of device for presenting a hard
copy of information, such as a printer, and other types of output
devices include speakers or any device for providing information in
audio form.
[0108] Examples of computer system 100 include dedicated server
computers, such as bladed servers, personal computers, laptop
computers, notebook computers, palm top computers, network
computers, mobile devices, or any processor-controlled device
capable of executing a web browser or other type of application for
interacting with the system. If computer system 100 is a server,
server 100 may not include input device 116, display device 110 and
output device 108. Rather, server 100 may be connected, e.g.,
through a network connection to a stand-alone work station (another
computer system) that has such devices.
[0109] Although only one computer system 100 is shown in detail,
the system for using a wellness assessment behavioral health kiosk
10 may use multiple computer systems or servers as necessary or
desired to support the users, as described above. Aspects may also
use back-up or redundant servers to prevent network downtime in the
event of a failure of a particular server. In addition, although
computer system 100 is depicted with various components, one
skilled in the art will appreciate that the server can contain
additional or different components. In addition, although aspects
of an implementation consistent with the above are described as
being stored in memory, one skilled in the art will appreciate that
these aspects can also be stored on or read from other types of
computer program products or computer-readable media, such as
secondary storage devices, including hard disks, floppy disks, or
CD-ROM; or other forms of RAM or ROM. Computer-readable media may
include instructions for controlling a computer system, such as the
computer system 100, to perform a particular method, such as
methods described above.
[0110] FIGS. 2A and 2B show a method 200 of using the wellness
assessment behavioral health kiosk 10, according to one aspect of
this disclosure. The method 200 may begin by providing a welcome
screen at block 202 to a user of the wellness assessment behavioral
health kiosk 10. At the welcome screen, the wellness assessment
behavioral health kiosk 10 may prompt the user to select from, for
example, two options. One option may be that the user is conducting
her first wellness assessment and therefore, the user completes the
full wellness assessment. Alternatively, the user may have already
previously conducted a wellness assessment and is at the facility
to conduct a follow-up visit. At block 204, the method 200 may
determine which option the user has selected. If the user selects
the option of a follow-up visit, the method 200 may proceed to
block 206. If the user selects conducting an entire wellness
assessment, the method 200 may proceed to block 210.
[0111] At block 206, the method may prompt the user to complete a
follow-up assessment. The follow-up assessment may ask the user a
variety of questions related to the user. For example, the
follow-up assessment may ask the user questions about the user's
progress. These questions may be tailored to the previous wellness
assessment the user may have taken. For example, if the user had
previously talked to her healthcare professional about an alcohol
abuse problem, the method 200 may ask the user follow-up questions
related to alcohol abuse. For example, the method 200 may ask the
user if the user has decreased the amount of alcohol the user
consumes per week or if she has sought additional help, for
example, attending Alcoholics Anonymous meetings. These questions
may be set without customization to the user. Alternatively, the
questions may be tailored to the user based on, for example, notes
previously made entered into the wellness kiosk by the user's
healthcare professional. Once the user completes the follow-up
questionnaire, the method 200 may proceed to block 208.
[0112] At block 208, the method 200 may output the results of the
follow-up questionnaire completed in block 206. For example, the
method 200 may print the questions and answers of the follow-up
questionnaire. Alternatively, or additionally, the method 200 may
output the results of the follow-up questionnaire electronically.
For example, the method 200 may output the results as an email to
the user's healthcare professional. Alternatively, or additionally,
the method 200 may output the results to the user's electronic
health records. For example, the results may be incorporated into
the user's preexisting electronic health records. If the user does
not have a preexisting electronic health record, then the method
may generate a new electronic health record for the user.
[0113] If, at block 204, the user selected to start a new wellness
assessment, the method 200 may continue to block 210. At block 210,
the wellness assessment behavioral health kiosk 10 may prompt the
user to enter demographic information. The demographic information
may include, for example, the user's age, weight, height,
ethnicity, gender, education, household composition, employment
status, and other factors that may be useful in diagnosing the
user. One of ordinary skill in the art would readily recognize that
many other demographic aspects may be useful in diagnosing the
user. Once the user has entered the demographic information, the
method 200 may proceed to block 212.
[0114] At block 212, the wellness assessment behavioral health
kiosk 10 may prompt the user to answer a series of behavioral
questions. For example, the wellness assessment behavioral health
kiosk 10 may ask the user to complete a series of questions related
to the frequency of depressed mood and anhedonia over a period of
time. For example, one common questionnaire used in diagnosing
mental health conditions is the Patient Health Questionnaire-2
(PHQ-2). The PHQ-2 is used generally to screen for depressive
behavior rather than a final diagnosis. Using the PHQ-2, the
wellness assessment behavioral health kiosk 10 may ask the user
about the user's frequency of depressed mood and anhedonia over the
past two weeks. Based on the answers to the questions presented by
the PHQ-2, the wellness assessment behavioral health kiosk 10 may
assign a score to the user. In one aspect of this disclosure, the
higher the score the wellness assessment behavioral health kiosk 10
assigns to the user's responses, the more likely that the user may
be depressed. When the user has completed the behavioral health
questions in block 212, the method 200 may proceed to block
214.
[0115] At block 214, the wellness assessment behavioral health
kiosk 10 may analyze the score generated in block 212. For example,
the wellness assessment behavioral health kiosk 10 may have a
minimum threshold for screening for depression. For example, the
wellness assessment behavioral health kiosk 10 may determine that
the user may have depression if the score is equal to or higher
than two. One of ordinary skill in the art would readily recognize
that any threshold may be used. For example, the lower the
threshold, the more sensitive the wellness assessment behavioral
health kiosk 10 may be to detecting depressive behavior.
Conversely, the higher the threshold, the less sensitive the
wellness assessment behavioral health kiosk 10 may be to detecting
depressive behavior. If the threshold in block 214 has not been
met, then the method 200 may proceed to block 216. If the threshold
in block 214 has been met, then the method 200 may proceed to block
222.
[0116] At block 216, the wellness assessment behavioral health
kiosk 10 may ask the user to complete a post-traumatic stress
disorder (PTSD) questionnaire. For example, the wellness assessment
behavioral health kiosk 10 may ask the user questions from the
primary care PTSD (PC-PTSD) screen. For example, the PC-PTSD screen
may include an introductory sentence or paragraph to cue
respondents to traumatic events. The PC-PTSD screen may then ask a
series of questions to the user to detect PTSD. Based on the
answers to the questions, the wellness assessment behavioral health
kiosk 10 may generate a score. Once the user has completed the PTSD
questionnaire in block 216, the method 200 may proceed to block
218.
[0117] At block 218, the wellness assessment behavioral health
kiosk 10 may analyze the generated PTSD questionnaire score to
determine the likelihood that the user suffers from PTSD. For
example, the wellness assessment behavioral health kiosk 10 may
have a minimum threshold for screening for PTSD. For example, the
wellness assessment behavioral health kiosk 10 may determine that
the user may have PTSD if the score is equal to or higher than
three. One of ordinary skill in the art would readily recognize
that any threshold may be used. For example, the lower the
threshold, the more sensitive the wellness assessment behavioral
health kiosk 10 may be to detecting PTSD. Conversely, the higher
the threshold, the less sensitive the wellness assessment
behavioral health kiosk 10 may be to detecting PTSD. If the
threshold in block 218 has not been met, then the method 200 may
proceed to block 224. If the threshold in block 218 has been met,
then the method 200 may proceed to block 220.
[0118] At block 220, the wellness assessment behavioral health
kiosk 10 may ask the user to complete a second PTSD questionnaire.
This second PTSD questionnaire may ask questions in more depth than
the PTSD questionnaire in block 216. For example, the wellness
assessment behavioral health kiosk 10 may ask questions that are
found in the PTSD CheckList--Civilian Version. The wellness
assessment behavioral health kiosk 10 may generate a score based on
the answers the user provided to the questions. Once the user has
completed the second PTSD questionnaire, the method 200 may proceed
to block 224.
[0119] If the user did meet the threshold in block 214, the method
200 may proceed to block 222. At block 222, the wellness assessment
behavioral health kiosk 10 may ask the user to complete a more
in-depth depression severity questionnaire. For example, the
wellness assessment behavioral health kiosk 10 may ask the user to
complete a Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 may be
used to screen, diagnose, monitor, and measure a severity of
depression. The more in-depth depression severity questionnaire of
block 222 may be a continuation of the questionnaire presented in
block 212. Based on the answers provided by the user, the wellness
assessment behavioral health kiosk 10 may generate a score that
represents, for example, whether the user exhibits depressive
behavior and the severity of any depressive behavior. After block
222 is complete, the method 200 may proceed to block 224.
[0120] At block 224, the wellness assessment behavioral health
kiosk 10 may ask the user to complete a bipolar risk factor
questionnaire. For example, the wellness assessment behavioral
health kiosk 10 may ask the user if the user had ever been
diagnosed with bipolar disorder or had ever experienced a manic
episode. Additionally, or alternatively, the wellness assessment
behavioral health kiosk 10 may ask the user about the user's family
history. For example, the wellness assessment behavioral health
kiosk 10 may ask if any of the user's parents, siblings, or other
ancestors had suffered from bipolar disorder or had ever
experienced a manic episode. Additionally, or alternatively, the
wellness assessment behavioral health kiosk 10 may ask the user for
additional details regarding the subject's depression. For example,
the wellness assessment behavioral health kiosk 10 may prompt the
user for information, such as how suddenly the depression symptoms
manifested. Additionally, or alternatively, the wellness assessment
behavioral health kiosk 10 may ask the user when the first
depressive episode occurred. For example, the wellness assessment
behavioral health kiosk may ask the user if the first depressive
episode occurred before a certain age, such as eighteen years old.
Once the user has answered these questions, the wellness assessment
behavioral health kiosk 10 may generate a score based on the
answers provided by the user. After block 224 is complete, the
method 200 may proceed to block 226.
[0121] At block 226, the wellness assessment behavioral health
kiosk 10 may determine, based on the score generated in block 224,
whether the user should be further screened for a mood disorder.
For example, the wellness assessment behavioral health kiosk 10 may
have a minimum threshold for screening for bipolar disorder risk.
For example, the wellness assessment behavioral health kiosk 10 may
determine that the user may have bipolar disorder if the score is
equal to or higher than one. One of ordinary skill in the art would
readily recognize that any threshold may be used. For example, the
lower the threshold, the more sensitive the wellness assessment
behavioral health kiosk 10 may be to detecting bipolar disorder.
Conversely, the higher the threshold, the less sensitive the
wellness assessment behavioral health kiosk 10 may be to detecting
bipolar disorder. If the threshold in block 226 has not been met,
then the method 200 may proceed to block 230. If the threshold in
block 226 has been met, then the method 200 may proceed to block
228.
[0122] At block 228, the wellness assessment behavioral kiosk 100
may ask the user additional questions related to the user's mood.
After the user has answered the questions, the wellness assessment
behavioral kiosk 100 may generate a score based on the answers.
When block 228 is finished, the method 200 may proceed to block
230.
[0123] At block 230, the wellness assessment behavioral kiosk 100
may ask the user pre-screening questions related to alcohol, drug,
and tobacco use. For example, the wellness assessment behavioral
kiosk 100 may use the Screening, Brief Intervention, and Referral
to Treatment (SBIRT) pre-screening questions. For example, the
SBIRT pre-screen may ask when the user last had a certain amount of
drinks in a given period of time, such as four drinks in one day.
Additionally, or alternatively, the SBIRT pre-screen may ask the
user if the user has used drugs within a period of time, such as
within the last twelve months. Additionally, or alternatively, the
SBIRT pre-screen may ask the user if the user uses tobacco in any
form. Once the user has answered these questions, the wellness
assessment behavioral kiosk 100 may store the answers. The stored
answers may be used later in the method 200, as described below.
Once block 230 is complete, the method proceeds along path A, which
continues on to FIG. 2B. Path A may branch into three different
directions. For example, path A may continue to block 232.
[0124] At block 232, the wellness assessment behavioral kiosk 100
may determine if the user has answered positively to alcohol. In
other words, block 232 may determine if the user has used alcohol
as described above with reference to block 230. If the user is not
positive for alcohol, then the method 200 may proceed to block 238.
However, if the user is positive for alcohol, then the method 200
may proceed to block 234.
[0125] At block 234, the wellness assessment behavioral kiosk 100
may ask the user to complete an alcohol use disorders
questionnaire. For example, the alcohol use disorders questionnaire
may be the Alcohol Use Disorders Identification Test (AUDIT). In
one aspect, the wellness assessment behavioral kiosk 100 may use
AUDIT to ask the user ten questions to gauge the user's alcohol
consumption, drinking behaviors, and alcohol-related problems. Such
questions may include questions regarding the frequency of alcohol
use, the type of alcohol used, and whether the alcohol use has
impaired the user's ability to function in day to day life. The
wellness assessment behavioral kiosk may generate a score based on
the answers the user provided in response to the alcohol use
disorders questionnaire. Once the user has finished answering the
questionnaire, the method 200 may proceed in two parallel paths.
For example, in one of the parallel paths, the method 200 may
proceed to block 238. In the other parallel path, the method 200
may proceed to block 236, which is analyzed in the context of both
alcohol and drugs.
[0126] At block 238, the wellness assessment behavioral health
kiosk 10 may ask the user to complete a set of resilience
questions. Once the user has answered the resilience questions, the
method 200 may proceed to block 240.
[0127] At block 240, the wellness assessment behavioral health
kiosk 10 may output the results of the wellness assessment. For
example, the method 200 may print the questions and answers of the
assessment. Alternatively, or additionally, the method 200 may
output the results of the assessment electronically. For example,
the method 200 may output the results as an email to the user's
healthcare professional. Alternatively, or additionally, the method
200 may output the results to the user's electronic health records.
For example, the results may be incorporated into the user's
preexisting electronic health records. If the user does not have a
preexisting electronic health record, then the method may generate
a new electronic health record for the user. The method 200 may
then end.
[0128] Another parallel path the method 200 may have taken after
block 230 is block 242, which determines if the user has answered
positively for drugs. If the user has answered positively for
drugs, the method 200 may proceed to block 244.
[0129] At block 244, the wellness assessment behavioral kiosk 100
may ask the user to complete a drug abuse screening questionnaire.
In one aspect, the drug abuse screening questionnaire may be the
Drug Abuse Screening Test (DAST). The DAST may ask, for example,
ten questions about the user's drug use in the past twelve months.
The DAST asks only about drug use, not alcohol or tobacco. One of
ordinary skill in the art would readily recognize that tests other
than DAST may be used and that these other tests may ask questions
about other behavior, including alcohol and tobacco use. For
example, the wellness assessment behavioral health kiosk may ask
the user for what types of drugs the user uses, the frequency of
use for each type of drug, the form in which the user uses the
drug, and other questions designed to explore the user's drug use
behavior. Once the user has completed the drug abuse screening
questionnaire, the method 200 may proceed to block 246.
[0130] At block 246, the wellness assessment behavioral kiosk 100
may determine if the user has answered positively for both alcohol
and drug use. If the user has answered positively for both alcohol
and drug use, the method 200 may proceed to block 234, as described
above. However, if the user has not answered positively for both
drugs and alcohol, the method 200 may proceed to block 248.
[0131] At block 248, the wellness assessment behavioral kiosk 100
may ask the user to complete a set of resilience questions. These
resilience questions may be the same as or similar to the
resilience questions asked in block 238, as described above. Once
the user has completed block 248, the method 200 may proceed to
block 250.
[0132] At block 250, the wellness assessment behavioral kiosk 100
may output the results of the wellness assessment. Block 250 is
similar to block 240, as described above.
[0133] If the user did not answer positively for drugs at block
242, the method 200 may proceed directly to block 248 and then to
block 250, as described above.
[0134] Another parallel path method 200 may take after block 230 is
block 252, which determines if the user has answered positively for
tobacco use. If the user has indicated that the user uses tobacco,
then the method 200 may proceed to block 254.
[0135] At block 254, the method 200 may ask the user if the user is
interested in quitting tobacco use. Once the user completes this
block 254, the method 200 may proceed to block 256.
[0136] At block 256, the wellness assessment behavioral kiosk 100
may ask the user a series of resilience questions. These questions
may be identical or similar to the resilience questions asked in
blocks 238 and 248. Once block 256 is completed, the method 200 may
proceed to block 258.
[0137] At block 258, the wellness assessment behavioral kiosk 100
may output the results of the wellness assessment. The wellness
assessment behavioral kiosk 100 may output the results as described
above in, for example, blocks 240 and 250. However, if the user was
not positive for tobacco at block 252, then the method 200 may
proceed directly to blocks 256 and then 258, as described above.
The method 200 may then end.
[0138] At each block of the method 200, the wellness assessment
behavioral kiosk 100 may allow the user to input additional
information. For example, for a given questionnaire, the
questionnaire may allow the user to input sentences, short answers,
or paragraphs to elaborate on the answers already given. In this
way, the user is able to provide a more comprehensive answer that
may provide nuance lost in the questionnaire.
[0139] Additionally, in another aspect of this disclosure,
healthcare professionals may be able to specify certain important
words or phrases in any of the longer responses provided by the
user. For example, if the user provides, in a long for answer, that
the user is contemplating suicide by using the word suicide, the
wellness assessment behavioral kiosk 100 may be configured to
highlight the word suicide in the outputted results. These
important words or phrases may be generally applicable to all users
of the wellness assessment behavioral kiosk 100. Additionally, or
alternately, the important words or phrases may be tailored for
each user, based on previously provided answers or course of
treatment. In this way, the healthcare professional may be quickly
alerted to areas of particular concern.
[0140] Moreover, as described in the description of the method 200,
various blocks may generate a score based on the responses given by
the user. The method 200 may then compare the generated score to
various score thresholds. In one aspect of this disclosure, a score
threshold may be pre-defined and unchangeable. In another aspect of
this disclosure, the score threshold may be configurable by, for
example, a healthcare professional. Moreover, in another aspect of
this disclosure, the score threshold may be tailored for each user.
For example, if a user has shown in the past to be more vulnerable
to alcohol abuse, the score threshold may be lower for this user to
attempt to prevent the alcohol abuse from becoming worse. Moreover,
in another aspect, the score threshold may be dependent on
demographic information. For example, if a user indicates that the
user is divorced, the score threshold for that user for depressive
behavior may be reduced.
[0141] FIG. 3 shows another exemplary method 300 of using the
wellness assessment behavioral health kiosk 10. The method 300 may
begin at block 302. At block 302, the wellness assessment
behavioral health kiosk 10 may receive input from a user in
response to a mental competency assessment. For example, the
wellness assessment behavioral health kiosk 10 may receive input
from the user in response to various assessments, such as the
assessments described above, for example, in blocks 204, 206, 210,
212, 216, 220, 222, 224, 228, 230, 234, 238, 244, 248, 252, and 254
in method 200. After block 302 is complete, the method 300 may
proceed to block 304.
[0142] At block 304, the wellness assessment behavioral health
kiosk 10 may transmit the user input gathered in block 302 to a
healthcare professional. While FIG. 3 shows that block 304 follows
block 302, one of ordinary skill in the art would readily recognize
that the wellness assessment behavioral health kiosk 10 may
transmit the inputted information as the user inputs the
information or it may transmit the inputted information once all of
the information has been gathered. The user input may be
transmitted to another device, such as a computer located near a
healthcare professional. One of ordinary skill in the art would
readily recognize that any device capable of receiving such
information may receive the transmitted information. The user input
may be transmitted over a network, such as network 118. The
healthcare professional may be, for example, a primary physician.
There may also be more than one healthcare professional. For
example, the information may be transmitted to multiple healthcare
professionals who may analyze the information jointly. Based on the
analysis, the one or more healthcare professionals may generate a
recommendation based on the transmitted information. The
recommendation may include the mental competency of the user. The
recommendation may also include a treatment plan. After block 304
is complete, the method 300 may proceed to block 306.
[0143] At block 306, the wellness assessment behavioral health
kiosk 10 may receive the recommendation generated in block 304. The
recommendation generated in block 304 may be transmitted to the
wellness assessment behavioral health kiosk 10 using, for example,
a computer located near the healthcare professional. One of
ordinary skill in the art would readily recognize that any device
capable of transmitting such information may transmit the
recommendation. The recommendation may be transmitted over a
network, such as network 118. After block 306 is completed, the
method 300 may continue to block 308.
[0144] At block 308, the wellness assessment behavioral health
kiosk 10 may output the recommendation received in block 306. The
output may presented to the user who input information into the
wellness assessment behavioral health kiosk 10. Alternatively, or
additionally, the output may be presented to a third party. As
described above, the outputted recommendation may include a course
of treatment. After block 308 is complete, the method 300 may
end.
Method for Treating a Behavioral Disorder
[0145] Another aspect of the present application relates to a
method for treating a behavioral disorder in a subject in need
thereof. The method includes the steps of: prompting the subject
with at least one question on a display of a system for assessment
of a behavioral disorder of the subject, wherein the system
comprises the display, an input device, a processer and a database;
recording at least one response to the system, wherein the at least
one response comprises a long-form answer; analyzing the at least
one response by at least one health professional; determining by
the at least one health professional, based on the at least one
response, the behavioral disorder of the subject; and incorporating
the behavioral disorder of the subject into an electronic health
record associated with the subject. The method further comprises
administering to the subject at least one treatment effective for
the behavioral disorder.
[0146] In some embodiments, the method further comprises the step
of retrieving a medical history of the subject from a database and
accepting the at least one attribute from the medical history for
the determination of the behavioral disorder of the subject. In
some embodiments, the method further comprises the step of
presenting one or more questions about the medical history of the
subject and receiving responses to the one or more questions about
the medical history of the subject for the determination of the
behavioral disorder of the subject.
[0147] In some embodiments, the at least one attribute from the
medical history and/or the at least one response to the one or more
questions about the medical history triggers an automatic alert for
review by the at least one health professional if the at least one
attribute from the medical history and/or the at least one response
to the one or more questions about the medical history matches an
alert event in an alert database.
[0148] In some embodiments, the method comprises analyzing the at
least one response by two health professionals. In some further
embodiments, the at least one health professional is a mental
health professional. In still further embodiments, the mental
health professional is a psychiatrist. In other further
embodiments, the at least one health professional is a physician.
In yet other embodiments, the two health professionals are a
physician and a mental health professional.
[0149] In particular embodiments, the method further comprises the
step of converting the at least one response into an assessment
score based on a matrix.
[0150] There are numerous art-known therapeutic regimes for the
treatment of behavioral disorders. In certain embodiments, the
therapeutic regimes can include treatment with pharmacological
compounds that modulate the brain's serotonin and/or norepinephrine
systems. Such pharmacological compounds include, but are not
limited to, tricyclic antidepressants, selective serotonin reuptake
inhibitors (SSRI), selective norepinephrine reuptake inhibitors
(SNRI), and serotonin antagonist and reuptake inhibitors (SARI).
Specific exemplary pharmacological compounds include amitriptyline
(ELAVIL.TM.), clomipramine (ANAFRANIL.TM.), desipramine
(NORPRAMIN.TM.), doxepin (SINEQUANT.TM.), imipramine
(TOFRANIL.TM.), nortriptyline (PAMELORT.TM.), protriptyline
(VIVACTIL.TM.), fluoxetine (PROZAC.TM.), fluvoxamine (LUVOX.TM.),
paroxetine (PAXIL.TM.), sertaline (ZOLOFT.TM.), citalopram
(CELEXA.TM.), escitalopram oxalate (LEXAPRO.TM.) duloxetine
(CYMBALTA.TM.) venlafaxine (EFFEXOR.TM.), mirtazapine
(REMERON.TM.), nefazodone (SERZONE.TM.), and desyrel
(TRAZODONET.TM.). The foregoing pharmacological compounds can be
used singly or in any combination. The foregoing list of exemplary
compounds is not exhaustive of those known in the art, which can be
used in accordance with the present application.
[0151] Non-pharmacological therapeutic regimes include, for
example, psychotherapy, including exposure-based psychotherapy,
cognitive psychotherapy, and psycho-dynamically oriented
psychotherapy; electroconvulsive therapy (ECT).
[0152] The above description is for the purpose of teaching the
person of ordinary skill in the art how to practice the object of
the present application, and it is not intended to detail all those
obvious modifications and variations of it which will become
apparent to the skilled worker upon reading the description. It is
intended, however, that all such obvious modifications and
variations be included within the scope of the present application,
which is defined by the following claims. The aspects and
embodiments are intended to cover the components and steps in any
sequence which is effective to meet the objectives there intended,
unless the context specifically indicates the contrary.
* * * * *