WELL-FOUNDED

Guideline-oriented. Clinically compatible.

PHASE doesn't reinvent treatment — it makes visible what good treatment is already built on.

What we build on.

German S3 guideline on bipolar disorder

The German reference for diagnosis and treatment, published by DGBS (German Society for Bipolar Disorders) and DGPPN (German Association for Psychiatry). Psychoeducation, early warning signs and maintenance treatment are at the core of long-term care.¹

Life chart method

An established, validated method to document mood over months and years. Manic and depressive swings are recorded in four levels of severity each — the PHASE scale from −4 to +4 is based on exactly this.²

Social rhythms (IPSRT)

Regular sleep and a stable daily routine are seen as protective factors. That's why PHASE tracks both.³

International recommendations

International guidelines such as NICE and CANMAT/ISBD also see self-monitoring as part of relapse prevention.^4,5

EXAMPLE

The scale from −4 to +4.

The life chart method records manic and depressive swings in four levels of severity each.² PHASE uses exactly these levels: four steps down, four steps up, with the balanced state in between. This way the course in PHASE speaks the same language as a classic life chart.

−4−3−2−10+1+2+3+4

4 levels depressive

balanced

4 levels (hypo)manic

The same principle applies to language: terms such as early warning signs, as-needed medication or maintenance treatment follow the wording of the guidelines.¹ This way, people affected, family and friends and clinicians talk about the same things.

Why exactly these metrics?

Mood and energy tracked separately

According to DSM-5, increased activity and energy are core criteria of mania.⁶ Two axes also make mixed states visible that a single mood score would hide.

Sleep

A reduced need for sleep is one of the most common and earliest signs of mania.⁷ Changes in sleep often show up before mood clearly changes.

Medication including deviations

Taking medication irregularly is an important risk factor for relapse.⁵ As-needed medication and deviations are documented too, not just the plan.

Substances

Substance use affects the course and often occurs together with bipolar disorder.⁵

Daily routine

The basis for working on social rhythms.³

Free-text notes

Early warning signs are personal. What is "racing thoughts" for one person is a sudden urge to shop for the next. That's why context belongs right next to the value.

PHASE does not make diagnoses or give treatment recommendations. Whether PHASE measurably improves care is what we will examine in the planned pilot study with Universitätsklinikum Würzburg (University Hospital Würzburg).

Sources & further information

DGBS e.V. & DGPPN e.V.: S3-Leitlinie zur Diagnostik und Therapie Bipolarer Störungen. AWMF-Register-Nr. 038-019, in der jeweils aktuellen Fassung. – Links: DGBS · AWMF guideline register
Denicoff KD et al.: Validation of the prospective NIMH-Life-Chart Method (NIMH-LCM-p) for longitudinal assessment of bipolar illness. Psychological Medicine 2000; 30: 1391–1397. – Link To the study
Frank E et al.: Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Archives of General Psychiatry 2005; 62(9): 996–1004. – Link To the study
National Institute for Health and Care Excellence (NICE): Bipolar disorder: assessment and management. Clinical Guideline CG185. – Link To the guideline
Yatham LN et al.: Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disorders 2018; 20(2): 97–170. – Link To the guideline
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). 2013. (no link)
Jackson A, Cavanagh J, Scott J: A systematic review of manic and depressive prodromes. Journal of Affective Disorders 2003; 74(3): 209–217. – Link To the study