Project ID NS-MH2024_40

ThemeNS-MH

Co Supervisor 1A Institute of Psychiatry, Psychology & Neuroscience, School of Mental Health & Psychological Sciences, Social, Genetic & Developmental Psychiatry CentreWebsite

Co Supervisor 1B Institute of Psychiatry, Psychology & Neuroscience, School of Mental Health & Psychological Sciences, Department of Biostatistics & Health InformaticsWebsite

What predicts changes in ADHD symptoms and functioning over time? A remote monitoring study using wearable devices and smartphone Active and Passive Apps

People with attention deficit hyperactivity disorder (ADHD) are at an increased risk for negative outcomes, such as educational underachievement, unemployment, sleep problems and the development of many co-occurring psychiatric and physical disorders. Yet, crucially, individual long-term trajectories are highly variable, both in relation to the development of comorbid conditions and the severity of ADHD symptoms and impairment.

Late adolescence is a highly challenging and potentially critical period for young people with ADHD that can lay the foundations for diverging adulthood trajectories. Yet most young people with ADHD do not receive appropriate interventions during this vulnerable period due to both their disengagement from clinical services during the transition to adult ADHD services and our limited understanding of real-world targets for more holistic interventions. Remote measurement technology offers the potential to: a) obtain ongoing, long-term, real-world data at a level of detail that was previously impossible; b) identify real-world targets for intervention that include modifiable environmental factors and health behaviours; and c) transform monitoring, self-management, personalised treatment and engagement with clinical services during ADHD transition. Using our new ADHD Remote Technology (ART) system, which incorporates a wearable device and purpose-built smartphone Active and Passive Apps, we will remotely monitor young people with ADHD during the transition period.

Aim 1: To identify, with precision, the nature and timing of real-world changes that take place in the transition to adulthood for young people with ADHD (e.g. changes in clinical symptoms and functional impairment; healthy lifestyle behaviours (physical activity, sleep, daily structure, online lifestyle), social support, employment/studies).

Aim 2: Using the rich remote monitoring data to identify factors that predict such changes in the outcome measures.

Training on all aspects of the project, including advanced analyses on the rich temporal data, will be provided.

Main activities for each year of the PhD:

  • Year 1: Review background literature; obtain project-specific training (incl. advanced analyses); perform initial data and analysis tasks.
  • Year 2: Characterise the nature and timing of changes during transition to adulthood for young people with ADHD that are captured using active and passive remote monitoring.
  • Year 3: Identify factors that predict changes in outcome measures during the transition period.

Representative Publications

Sun S, Denyer H, Sankesara H, Deng Q, Ranjan Y, Conde P, Rashid Z, Bendayan R, Asherson P, Bilbow A, Groom M, Hollis C, Folarin AA, Dobson RJB, Kuntsi J. Remote Administration of ADHD-Sensitive Cognitive Tasks: A Pilot Study. J Atten Disord. 2023 Jun 2:10870547231172763. doi: 10.1177/10870547231172763.

Denyer H, Ramos-Quiroga JA, Folarin A, Ramos C, Nemeth P, Bilbow A, Woodward E, Whitwell S, Müller-Sedgwick U, Larsson H, Dobson RJ, Kuntsi J. ADHD Remote Technology study of cardiometabolic risk factors and medication adherence (ART-CARMA): a multi-centre prospective cohort study protocol. BMC Psychiatry. 2022 Dec 20;22(1):813. doi: 10.1186/s12888-022-04429-6.

Kuntsi J, Larsson H, Deng Q, Lichtenstein P, Chang Z. The Combined Effects of Young Relative Age and Attention-Deficit/Hyperactivity Disorder on Negative Long-term Outcomes. J Am Acad Child Adolesc Psychiatry. 2022 Feb;61(2):291-297. doi: 10.1016/j.jaac.2021.07.002.

Zhang, Y., Pratap, A., Folarin, A.A. …Dobson, R.J.B, RADAR-CND Consortium. Long-term participant retention and engagement patterns in an app and wearable-based multinational remote digital depression study. npj Digit. Med. 6, 25 (2023). https://doi.org/10.1038/s41746-023-00749-3.

Zhang Y, Folarin AA, Sun S, Cummins N, Vairavan S, Qian L, Ranjan Y, Rashid Z, Conde P, Stewart C, Laiou P, Sankesara H, Matcham F, White KM, Oetzmann C, Ivan A, Lamers F, Siddi S, Simblett S, Rintala A, Mohr DC, Myin-Germeys I, Wykes T, Haro JM, Penninx BWJH, Narayan VA, Annas P, Hotopf M, Dobson RJB, RADAR-CNS Consortium. Associations Between Depression Symptom Severity and Daily-Life Gait Characteristics Derived From Long-Term Acceleration Signals in Real-World Settings: Retrospective Analysis JMIR Mhealth Uhealth 2022;10(10):e40667. doi: 10.2196/40667

Zhang Y, Folarin AA, Sun S, Cummins N, Vairavan S, Bendayan R, Ranjan Y, Rashid Z, Conde P, Stewart C, Laiou P, Sankesara H, Matcham F, White KM, Oetzmann C, Ivan A, Lamers F, Siddi S, Vilella E, Simblett S, Rintala A, Bruce S, Mohr DC, Myin-Germeys I, Wykes T, Haro JM, Penninx BW, Narayan VA, Annas P, Hotopf M, Dobson RJ, RADAR-CNS consortium. Longitudinal Relationships Between Depressive Symptom Severity and Phone-Measured Mobility: Dynamic Structural Equation Modeling Study. JMIR Ment Health 2022;9(3):e34898. doi: 10.2196/34898