Electronic Ecological Momentary Assessment (EMA) in youth with bipolar disorder: Demographic and clinical predictors of electronic EMA adherence.


Journal

Journal of psychiatric research
ISSN: 1879-1379
Titre abrégé: J Psychiatr Res
Pays: England
ID NLM: 0376331

Informations de publication

Date de publication:
09 2019
Historique:
received: 13 03 2019
revised: 26 05 2019
accepted: 31 05 2019
pubmed: 9 6 2019
medline: 25 8 2020
entrez: 9 6 2019
Statut: ppublish

Résumé

Ecological momentary assessment (EMA) is increasingly used to characterize patients' daily lives, monitor mood, and test efficacy of treatment interventions. However, few studies have examined patient characteristics impacting adherence with EMA protocols, and to our knowledge, no such study has been conducted in youth with bipolar disorder (BD). As part of a larger observational study, 14- to 21-year-olds diagnosed with BD, and who were between episodes of illness (n = 39, 19.0 ± 2.05 Mean ± Standard Deviation years old, 74.4% female) and psychiatrically healthy controls (n = 47, 18.3 ± 2.40 years old, 66.0% female) completed baseline diagnostic and symptom severity interviews, and were instructed to complete diary assessments of mood, sleep, and behavior electronically three times per day for 21 consecutive days (i.e., in total 5418 (or 63 per person) diary entries). Multiple regression was used to examine effects of BD participants' demographic and clinical characteristics on diary completion rates. 53.8 ± 9.3 diary entries per person were actually completed. Adherence rates were high (87.5% of healthy controls and 80.4% of adolescents with BD), but were still significantly poorer in youth with BD. Adequate adherence (≥80%) rates were also significantly poorer in youth with BD relative to healthy controls (56.4% versus 83.0%). Among youth with BD, more lifetime suicide attempts and higher current mood elevation symptom severity predicted significantly poorer adherence. Limited sample size/generalizability. Findings highlight the importance of considering the impact of patient characteristics on adherence with EMA protocols among youth with severe mental illness.

Sections du résumé

BACKGROUND
Ecological momentary assessment (EMA) is increasingly used to characterize patients' daily lives, monitor mood, and test efficacy of treatment interventions. However, few studies have examined patient characteristics impacting adherence with EMA protocols, and to our knowledge, no such study has been conducted in youth with bipolar disorder (BD).
METHODS
As part of a larger observational study, 14- to 21-year-olds diagnosed with BD, and who were between episodes of illness (n = 39, 19.0 ± 2.05 Mean ± Standard Deviation years old, 74.4% female) and psychiatrically healthy controls (n = 47, 18.3 ± 2.40 years old, 66.0% female) completed baseline diagnostic and symptom severity interviews, and were instructed to complete diary assessments of mood, sleep, and behavior electronically three times per day for 21 consecutive days (i.e., in total 5418 (or 63 per person) diary entries). Multiple regression was used to examine effects of BD participants' demographic and clinical characteristics on diary completion rates.
RESULTS
53.8 ± 9.3 diary entries per person were actually completed. Adherence rates were high (87.5% of healthy controls and 80.4% of adolescents with BD), but were still significantly poorer in youth with BD. Adequate adherence (≥80%) rates were also significantly poorer in youth with BD relative to healthy controls (56.4% versus 83.0%). Among youth with BD, more lifetime suicide attempts and higher current mood elevation symptom severity predicted significantly poorer adherence.
LIMITATIONS
Limited sample size/generalizability.
CONCLUSIONS
Findings highlight the importance of considering the impact of patient characteristics on adherence with EMA protocols among youth with severe mental illness.

Identifiants

pubmed: 31176107
pii: S0022-3956(19)30309-7
doi: 10.1016/j.jpsychires.2019.05.026
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

14-18

Subventions

Organisme : NIMH NIH HHS
ID : K01 MH100433
Pays : United States

Informations de copyright

Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.

Auteurs

Anda Gershon (A)

Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States.

Christopher N Kaufmann (CN)

Division of Geriatrics and Gerontology, Department of Medicine, University of California San Diego, La Jolla, CA, United States.

John Torous (J)

Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.

Colin Depp (C)

Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.

Terence A Ketter (TA)

Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States. Electronic address: tketter@stanford.edu.

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