Device, system, and method for treating psychiatric disorders

• US 8,439,686 B2
• Filed: 07/10/2009
• Issued: 05/14/2013
• Est. Priority Date: 07/10/2008
• Status: Active Grant

• Current Assignee: The Evermind Group, LLC
• Original Assignee: Claudia Zayfert, James Albert Cartreine
• Inventors: Cartreine, James Albert, Zayfert, Claudia
• Primary Examiner(s): DOUGHERTY, SEAN PATRICK
• Application Number:
  US12/501,156
• Publication Number:
  US 20100010371A1
• Time in Patent Office: 1,404 Days
• Field of Search: 434/236, 600/558, 600/559
• US Class Current: 434/236
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/0531 Measuring skin impedance
• CPC Class Codes: A61B 5/16 Devices for psychotechnics using teaching or educational appliances G09B1/00 - G09B7/00; Testing reaction times ; Devices for evaluating the psychological state
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/486 Bio-feedback A61B5/375 takes precedence
• CPC Class Codes: A61M 2021/0016 by the smell sense
• CPC Class Codes: A61M 2021/0027 by the hearing sense
• CPC Class Codes: A61M 2021/005 images, e.g. video
• CPC Class Codes: A61M 21/00 Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 2205/3375 Acoustical, e.g. ultrasonic, measuring means
• CPC Class Codes: A61M 2205/3553 remote, e.g. between patient's home and doctor's office
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 2230/30 Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/42 Rate
• CPC Class Codes: A61M 2230/60 : Muscle strain, i.e. measured on the user
• CPC Class Codes: A61M 2230/65 : Impedance, e.g. conductivity, capacity
• CPC Class Codes: G16H 20/70 : relating to mental therapies, e.g. psychological therapy or autogenous training

Abstract

Provided are a device, system, and method for treating a patient having posttraumatic stress disorder (PTSD) or other such psychiatric disorder. An event being recounted by the patient is recorded and a sensory environment of the patient is controlled so as to administer exposure therapy to the patient. Patient mental state may be monitored during administration of the exposure therapy to the patient, and the exposure therapy may be varied in correspondence to the monitored mental state of the patient. In one embodiment, hierarchy assembly means creates a treatment hierarchy based on input from the patient, and hierarchy navigation means navigates within the treatment hierarchy in response to the mental state of the patient.

Claims

1. A computer-based system for treating a patient having a psychiatric disorder, the system comprising:

a memory; and

a processor configured to perform the steps of;

recording a patient'"'"'s recounting of an event that was experienced by the patient;

parsing or dividing the recounted event into one or more stimuli for subsequent playback to the patient;

generating a mental state metric for each of the one or more stimuli, wherein each mental state metric is indicative of a mental state of the patient at a time when an associated stimulus was being recounted; and

causing a selected one of the stimuli to be played back to the patient one or more times,

wherein a mental state of the patient is monitored as the selected one of the stimuli is played back one or more times, and

wherein a different one of the stimuli is selected for subsequent play back to the patient based on the monitored mental state of the patient.

2. The computer-based system of claim 1, further comprising:

a patient interface for playing back one or more of the stimuli, including providing or directing visual and audio exposure; and

a sensor for monitoring the mental state of the patient, including sensing a level of patient anxiety or distress.

3. The computer-based system of claim 1, wherein the processor is further configured to perform the steps of:

associating, with each of the stimuli, a first mental state metric value representative of the monitored mental state of the patient when the patient recounted the stimulus; and

associating, with each of the stimuli, a second mental state metric value representative of the monitored mental state of the patient when the stimuli was played back to the patient.

4. The computer-based system of claim 3 wherein the processor is furthermore configured to perform the step of:

varying a sequence of the stimuli to be played back to the patient in correspondence to the second mental state metric value until the second mental state metric value indicates habituation of the patient as compared with the first mental state metric value.

5. The computer-based system of claim 3 Wherein the processor is furthermore configured to perform the step of:

varying an intensity of at least one of the stimuli in correspondence to the second mental state metric value until the second mental state metric value indicates habituation of the patient as compared with the first mental state metric value.

6. The computer-based system of claim 3 wherein the processor is further configured to cause the system to provide a course of imaginal exposure therapy.

7. The computer-based system of claim 6 wherein the imaginal exposure therapy is implemented by playing back a recording in the voice or image of the patient.

8. The computer-based system of claim 3 adapted to provide a course of in vivo exposure therapy.

9. The computer-based system of claim 8 wherein the in vivo exposure therapy is implemented through use of a portable computing device that guides the patient to approach and be exposed to at least one of the stimuli.

10. The computer-based system of claim 3 wherein the first and second mental state metric values are based at least in part on. self-reported mental state information.

11. The computer-based system of claim 3 wherein the first and second mental state metric values are based at least in part on speech of the patient.

12. The computer-based system of claim 3 wherein the first and second mental state metric values are based at least in part on facial affect of the patient.

13. The computer-based system of claim 3 wherein-the first and second mental state metric values are based at least in part on at least one biological or physiological characteristic of the patient.

14. The computer-based system of claim 13 wherein the at least one biological or physiological characteristic includes a characteristic selected from the group consisting of breathing, heart rate, blood pressure, peripheral resistance, skin temperature, skin conductance, sweat gland activity, facial electromyographic response, peripheral muscle activity, restlessness, and shifting in chair.

15. The computer-based system of claim 3 wherein the processor is furthermore configured to perform the step of:

delivering coping statements to the patient in correspondence to the second mental state metric value.

16. The computer-based system of claim 1, wherein the processor is further configured to store in the memory a psychiatric disorder treatment data structure, the data structure comprising:

a plurality of the stimuli parsed from the event recounted by the patient; and

a historical record of the mental state metrics respectively associated with each of the stimuli;

wherein the mental state metrics respectively indicate monitored mental state of the patient during the recounting of the event by the patient and during at least one instance when at least one of the stimuli was used to administer exposure therapy to the patient.

17. The computer-based system of claim 3, wherein the processor is further configured to perform the steps of:

associating with each of the stimuli a mental state metric value representative of the monitored mental state of the patient when the patient experienced the stimulus; and

identifying one or more of the stimuli as being salient to treating the patient based on the mental state metrics associated with each of the stimuli.

18. The computer-based system of claim 3 further comprising:

hierarchy assembly means for creating a treatment hierarchy based on input from the patient; and

hierarchy navigation means for navigating within the treatment hierarchy in response to the mental. state of the patient.

19. A non-transitory computer-readable medium having stored thereon computer-executable instructions for configuring a processor to perform the steps of:

monitoring a mental state of a patient;

recording an event being recounted by the patient;

parsing the event into a plurality of stimuli;

controlling a sensory environment of the patient so as to administer exposure therapy to the patient based on at least one of the stimuli;

associating, with each of the stimuli on which the exposure therapy is based, a first mental state metric value representative of the monitored mental state of the patient when the patient recounted the stimulus; and

associating, with each of the stimuli on which the exposure therapy is based, a second mental state metric value representative of the monitored mental state of the patient when the exposure therapy based on the stimulus was administered to the patient.

20. A computer-readable medium according to claim 19 having further stored thereon computer-executable instructions for configuring a processor to perform the step of:

varying a sequence of the stimuli on which the exposure therapy is based in correspondence to the second mental state metric value until the second mental state metric value indicates habituation of the patient as compared with the first mental state metric value.

21. A computer-readable medium according to claim 19 having further stored thereon computer-executable instructions for configuring a processor to perform the step of:

varying an intensity of at least one of the stimuli on which the exposure therapy is based in correspondence to the second mental state metric value until the second mental state metric value indicates habituation of the patient as compared with the first mental state metric value.

22. A computer-readable medium according to claim 19

wherein the controlled sensory environment is an. imaginal environment implemented by playing back a recording of the voice or image of the patient.