Experienced Burden of and Adherence to Smartphone-Based Ecological Momentary Assessment in Persons with Affective Disorders
Abstract
:1. Background
2. Methods
2.1. Study Design and Participants
2.2. Smartphone-Based Ecological Momentary Assessment Protocol
2.3. Measurements
2.3.1. Baseline Characteristics
2.3.2. Momentary Affective States
2.4. Outcomes
2.4.1. Momentary Burden
2.4.2. Experienced Burden Over the Whole Monitoring Period
2.4.3. Adherence to the Daily EMA Questionnaires
2.5. Statistical Analyses
3. Results
3.1. Sample Characteristics
3.2. Burden
3.2.1. Person-Mean Momentary Burden
3.2.2. Association Between Affective States and Momentary Burden
3.2.3. Experienced Burden Over Whole Monitoring Period
3.3.1. Adherence Rates
3.3.2. Reasons for Missing Daily EMA Questionnaires
4. Discussion
5. Conclusions
Author Contributions
Acknowledgments
Conflicts of Interest
References
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Persons with Current Affective Disorder(S) Persons (n = 100) | Remitted Persons (n = 190) | Healthy Controls (n = 94) | Total (n = 384) | Test Value | p Value | ||
---|---|---|---|---|---|---|---|
Demographic characteristics | |||||||
Age | 50.5 (41.5–59.0) | 48.5 (36.0–61.0) | 54.0 (4.0–62.0) | 51.0 (38.0–61.0) | H(2) = 4.25 | 0.12 | |
Gender | |||||||
Female | 64 (64.0) | 132 (69.5) | 51 (54.3) | 238 (67.0) | χ2(2) = 6.35 | 0.04 | |
Male | 36 (36.0) | 58 (30.5) | 43 (45.7) | 117 (33.0) | |||
Educational level | |||||||
Basic | 8 (8.0) | 4 (2.1) | 1 (1.1) | 13 (3.4) | χ2(4) = 14.51 | 0.01 | |
Intermediate | 49 (49.0) | 106 (55.8) | 38 (40.4) | 193 (50.3) | |||
High | 43 (43.0) | 80 (42.1) | 55 (58.5) | 178 (46.4) | |||
Working hours (a week) | 10.0 (0.0–32.0) | 20.0 (0.0–32.0) | 30.0 (0.0–37.0) | 20.0 (0.0–35.5) | H(2) = 10.22 | 0.01 | |
DSM-IV-R Diagnosis | Current | Lifetime | |||||
One more or anxiety disorder | 71(71.0) | 142 (74.7) | |||||
One or more depressive disorder | 61 (61.0) | 163 (85.8) | |||||
Generalized anxiety disorder | 12 (12.0) | 69 (36.3) | |||||
Social phobia | 35 (35.0) | 86 (45.3) | |||||
Panic disorder with agoraphobia | 6 (6.0) | 41 (21.6) | |||||
Panic disorder without agoraphobia | 13 (13.0) | 31 (16.3) | |||||
Agoraphobia | 22 (22.0) | 32 (16.8) | |||||
Major depressive disorder | 57 (57.0) | 160 (84.2) | |||||
Dysthymia | 15 (15.0) | 52 (27.4) | |||||
Number of affective disorders* | Current | Lifetime | |||||
1 | 61 (61.0) | 64 (33.7) | |||||
2 | 23 (23.0) | 45 (23.7) | |||||
3 | 12 (12.0) | 39 (20.5) | |||||
4 | 3 (3.0) | 22 (11.6) | |||||
5 | 1 (1.0) | 10 (5.3) | |||||
6 | 0 (0.0) | 8 (4.2) | |||||
7 | 0 (0.0) | 2 (1.1) |
Regression Coefficient (Standard Error) | 95%CI | Test Value | p Value | ||
---|---|---|---|---|---|
Positive affect and momentary burden | |||||
Positive affect (PA) * | −0.23 (0.02) | −0.27–0.19 | χ2(1) = 130.77 | <0.0001 | |
+ diagnosis groups | −0.22 (0.02) | −0.26–0.18 | χ2(1) = 114.36 | <0.0001 | |
+ weekly working hours | −0.23 (0.02) | −0.27–0.19 | χ2(1) = 133.58 | <0.0001 | |
+ gender | −0.23 (0.02) | −0.27–0.19 | χ2(1) = 131.38 | <0.0001 | |
+ age | −0.23 (0.02) | −0.27–0.19 | χ2(1) = 120.83 | <0.0001 | |
+ educational level | −0.23 (0.02) | −0.27–0.19 | χ2(1) = 134.67 | <0.0001 | |
+ PA × diagnosis groups | |||||
Persons with current affective disorders | |||||
Remitted persons † | 0.00 (0.05) | −0.09–0.10 | χ2(1) = 0.01 | 0.92 | |
Healthy controls † | −0.00 (0.07) | −0.13–0.13 | χ2(1) = 0.00 | 0.99 | |
+ PA × weekly working hours | 0.00 (0.00) | −0.00–0.00 | χ2(1) = 0.23 | 0.63 | |
+ PA × gender ‡ | −0.09 (0.04) | −0.17–0.00 | χ2(1) = 3.77 | 0.05 | |
+ PA × age | −0.00 (0.00) | −0.00–0.00 | χ2(1) = 0.31 | 0.58 | |
+ PA × educational level | |||||
Low | |||||
Moderate § | −0.07 (0.07) | −0.22–0.08 | χ2(1) = 0.90 | 0.34 | |
High § | −0.13 (0.07) | −0.28–0.02 | χ2(1) = 3.11 | 0.08 | |
Negative affect and momentary burden | |||||
Negative affect (NA) * | 0.30 (0.03) | 0.24–0.37 | χ2(1) = 80.53 | <0.0001 | |
+ diagnosis groups | 0.29 (0.03) | 0.22–0.36 | χ2(1) = 73.09 | <0.0001 | |
+ weekly working hours | 0.31 (0.03) | 0.24–0.38 | χ2(1) = 83.94 | <0.0001 | |
+ gender | 0.31 (0.03) | 0.24–0.37 | χ2(1) = 81.76 | <0.0001 | |
+ age | 0.30 (0.03) | 0.23–0.37 | χ2(1) = 73.79 | <0.0001 | |
+ educational level | 0.32 (0.03) | 0.25–0.38 | χ2(1) = 90.22 | <0.0001 | |
+ NA × diagnosis groups | |||||
Persons with current affective disorders | |||||
Remitted persons † | 0.05 (0.07) | −0.09–0.19 | χ2(1) = 0.48 | 0.49 | |
Healthy controls † | 0.09 (0.13) | −0.15–0.40 | χ2(1) = 0.54 | 0.46 | |
+ NA × weekly working hours | −0.00 (0.00) | −0.01–0.00 | χ2(1) = 1.09 | 0.30 | |
+ NA × gender ‡ | 0.04 (0.07) | −0.10–0.18 | χ2(1) = 0.33 | 0.57 | |
+ NA × age | 0.01 (0.00) | −0.00–0.01 | χ2(1) = 3.77 | 0.05 | |
+ NA × educational level | |||||
Low | |||||
Moderate § | 0.15 (0.14) | −0.12–0.42 | χ2(1) = 1.14 | 0.29 | |
High § | 0.21 (0.14) | −0.06–0.49 | χ2(1) = 2.28 | 0.13 | |
Stability of momentary burden | |||||
Time● | 0.00 (0.00) | 0.00–0.00 | χ2(1) = 2.83 | 0.09 |
Persons with Current Affective Disorders (n = 77) | Remitted Persons (n = 156) | Healthy Controls (n = 75) | Total (n = 321) | Test Value | p Value | |
---|---|---|---|---|---|---|
Amount of reasons | 2 (1–2) | 2 (1–2) | 1 (1–2) | 2 (1-3) | H(2) = 3.10 | 0.21 |
Main reasons for missing questionnaires | ||||||
Being busy with an activity | 52 (67.5) | 86 (55.1) | 46 (61.3) | 184 (57.3) | χ2(2) = 3.40 | 0.18 |
No network connection | 18 (23.4) | 38 (24.4) | 16 (21.3) | 72 (22.4) | χ2(2) = 0.26 | 0.88 |
Being asleep | 22 (28.6) | 36 (23.1) | 10 (13.3) | 68 (21.2) | χ2(2) = 5.31 | 0.07 |
Technical problems | 14 (18.2) | 29 (18.6) | 15 (20.0) | 58 (18.1) | χ2(2) = 0.94 | 0.95 |
Did not hear the smartphone | 17 (22.1) | 24 (15.4) | 14 (18.7) | 55 (17.1) | χ2(2) = 1.62 | 0.45 |
Did not bring the smartphone | 12 (15.6) | 26 (16.7) | 7 (9.3) | 45 (14.0) | χ2(2) = 2.26 | 0.32 |
Could not make themselves do it | 1 (1.3) | 0 (0.0) | 0 (0.0) | 1 (0.3) | χ2(2) = 3.01 | 0.22 |
Other reason | 15 (19.5) | 40 (25.6) | 18 (24.0) | 73 (22.7) | χ2(2) = 1.09 | 0.58 |
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van Genugten, C.R.; Schuurmans, J.; Lamers, F.; Riese, H.; Penninx, B.W.J.H.; Schoevers, R.A.; Riper, H.M.; Smit, J.H. Experienced Burden of and Adherence to Smartphone-Based Ecological Momentary Assessment in Persons with Affective Disorders. J. Clin. Med. 2020, 9, 322. https://doi.org/10.3390/jcm9020322
van Genugten CR, Schuurmans J, Lamers F, Riese H, Penninx BWJH, Schoevers RA, Riper HM, Smit JH. Experienced Burden of and Adherence to Smartphone-Based Ecological Momentary Assessment in Persons with Affective Disorders. Journal of Clinical Medicine. 2020; 9(2):322. https://doi.org/10.3390/jcm9020322
Chicago/Turabian Stylevan Genugten, Claire R., Josien Schuurmans, Femke Lamers, Harriëtte Riese, Brenda W. J. H. Penninx, Robert A. Schoevers, Heleen M. Riper, and Johannes H. Smit. 2020. "Experienced Burden of and Adherence to Smartphone-Based Ecological Momentary Assessment in Persons with Affective Disorders" Journal of Clinical Medicine 9, no. 2: 322. https://doi.org/10.3390/jcm9020322