Recently, Professor Nierenberg from Massachusetts General Hospital reported at the 2015 Annual American Psychiatric Association (APA) on the latest treatment protocol for mood disorders, which addresses problems that may arise at various points through the application of new medications, new devices, and the integration of patient resources and treatment apps. Predictive Analytics One important advance, according to Professor Nierenberg, is the upcoming predictive analytics, through which the concept of pre-detection makes it possible to predict the emotional events that precede an episode in patients with mood disorders using cutting-edge technology. When patients come for help, they are not always at the end of an episode or the beginning of an episode; it is the pain that drives them to seek help. Once they get past the in-between process, that’s when we need to intervene. But now we also need to process a lot of patient data that comes from the patient’s smartphone through a combination of GPS receptors, text and voice. Voice is one way to assess a patient’s mental state, and the technology assesses the patient’s mental state through their voice pattern analysis, rather than through the content of their conversations. In effect, it is a mathematical operation of the oscillations of the acoustic biological signal. It will record any objective changes reported by the patient prior to the episode. This may be a particularly valuable study considering that current methods of analyzing patients with mood disorders rely on patients’ self-observation, recall, and self-report. These are all the problems of patients with mood disorders. So, when we ask patients how they spent the period of their illness episode, patients typically spend 3-6 hours recalling it. These predictive analyses recognize real-time data that is happening to the patient and are, therefore, very exciting. Big Data He noted that, like many medical specialties, psychiatric care will increasingly make use of big data. There are already many projects in development, with patient communities, patient/practitioner collaborative networks, patient support sites and apps just a few of those in the works. There’s also the Patient-Centered Clinical Institute, which connects relevant patient-related resources and patient-centered clinical outcomes networks. It’s quite remarkable, and he sees it as a game-changer. It’s a research network for patient-centered research that allows patients to choose how they want to direct their treatment through self-reporting. The goal of this network is to transform the lives of patients with mood disorders through collaboration, prospective comparative efficacy research, and the ability to serve as an infrastructure for researchers and clinicians. This validated data comes not only from clinical interviews with patients, but also from an integrated electronic health network. The network, funded by the National Alliance on Mental Illness, the International Bipolar Foundation and other organizations, is designed to collect data from at least 50,000 patients. Professor Nierenberg also cited a number of other emerging treatment apps and websites, including Pacifica, MoodGym and the Now Matters Now website. He said Now Matters Now is a really good website that offers help to people with suicidal thoughts. And most people with suicidal thoughts don’t have suicidal thoughts when they come to your office for help. These are just a handful of cutting-edge strengths apps and websites that can grow over time. Emerging treatments At the conference, Professor Nierenberg presented the latest FDA-approved antidepressants, such as Fetzima (levomilnacipran, Forest Labs Inc.), Viibryd (vilazodone, Forest Labs Inc.) and Brintellix (vortioxetine, Takeda Pharmaceuticals). He pointed out the progress made in this field, starting with the application of lithium salts for the treatment of bipolar disorder, for which there is no specific treatment. Other drugs have been developed and repurposed for a different reason. Professor Nierenberg also discussed the application of glutamatergic drugs such as ketamine and riluzole for the treatment of mood disorders. It is intriguing to see how ketamine is gradually gaining ground in the absence of actual data. Ketamine clinics are also springing up, and we need to be vigilant about this. The most cutting-edge treatments for mood disorders are novel therapies such as transcranial magnetic stimulation, which is currently being used in studies of cranial injuries and is now being used in studies of mood disorders. Low-frequency magnetic wave stimulation is another innovation being studied, which uses peroxisome proliferator-activated receptors (PPARs) to modulate DNA in a neuroprotective manner. PPARs are found mainly in the nucleus and regulate the on and off of DNA. pgc-1 alpha is a protein associated with them and is responsible for activating PPARs. PPAR agonists, also known as thiazolidinediones, are used to treat metabolic syndrome and thiazolidinediones (pioglitazone) are now also used in studies of major depressive disorder and bipolar disorder. This is the first proof of concept for pioglitazone for bipolar depression, and one of those technologies that is astounding and at the forefront.