Electronic Ecological Momentary Assessment (EMA) in youth with bipolar disorder: Demographic and clinical predictors of electronic EMA adherence
Electronic Ecological Momentary Assessment (EMA) in youth with bipolar disorder: Demographic and clinical predictors of electronic EMA adherence
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DOI：
10.1016/j.jpsychires.2019.05.026
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发表时间：
2019-09-01
影响因子：
4.8
通讯作者：
Ketter, Terence A.
中科院分区：
文献类型：
--
作者：
Gershon, Anda;Kaufmann, Christopher N.;Ketter, Terence A.
背景：生态瞬时评估（EMA）越来越多地用于描述患者的日常生活、监测情绪和测试治疗干预的效果。然而，很少有研究检查影响 EMA 方案依从性的患者特征，据我们所知，尚未在患有双相情感障碍 (BD) 的青少年中进行此类研究。方法：作为一项大型观察性研究的一部分，14 至 21 岁被诊断为 BD 且处于疾病发作之间的人（n = 39、19.0 +/- 2.05 岁平均 +/- 标准差，74.4% 为女性）和精神健康 对照组（n = 47，18.3 +/- 2.40 岁，66.0% 女性）完成了基线诊断和症状严重程度访谈，并被指示连续 21 天每天 3 次以电子方式完成情绪、睡眠和行为日记评估（即总共 5418 条（或每人 63 条）日记条目）。使用多元回归来检查 BD 参与者的人口统计和临床特征对日记完成率的影响。结果：每人实际完成了 53.8 +/- 9.3 篇日记。遵守率很高（健康对照者为 87.5%，BD 青少年为 80.4%），但 BD 青少年的遵守率仍然明显较差。与健康对照组相比，BD 青少年的充分依从率 (>= 80%) 也显着较差（56.4% 比 83.0%）。在患有 BD 的青少年中，更多的终生自杀企图和更高的当前情绪升高症状严重程度预示着依从性显着较差。局限性：样本量有限/普遍性。结论：研究结果强调了考虑患者特征对患有严重精神疾病的青少年遵守 EMA 方案的影响的重要性。
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.