Maatoug Redwan, Peiffer-Smadja Nathan, Delval Guillaume, Brochu Térence, Pitrat Benjamin, Millet Bruno
Sorbonne Université, AP-HP, Service de psychiatrie adulte de la Pitié-Salpêtrière, Institut du Cerveau, ICM, F-75013, Paris, France.
National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, United Kingdom.
JMIR Form Res. 2021 Feb 24;5(2):e14179. doi: 10.2196/14179.
Ecological momentary assessment (EMA) is a promising tool in the management of psychiatric disorders and particularly depression. It allows for a real-time evaluation of symptoms and an earlier detection of relapse or treatment efficacy. The generalization of the smartphone in the modern world offers a new, large-scale support for EMA.
The main objective of this study was twofold: (1) to assess patients' compliance with an EMA smartphone app defined by the number of EMAs completed, and (2) to estimate the external validity of the EMA using a correlation between self-esteem/guilt/mood variables and Hamilton Depression Rating Scale (HDRS) score.
Eleven patients at the Pitié-Salpêtrière Hospital, Paris, France, were monitored for 28 days by means of a smartphone app. Every patient enrolled in the study had two types of assessment: (1) three outpatient consultations with a psychiatrist at three different time points (days 1, 15, and 28), and (2) real-time data collection using an EMA smartphone app with a single, fixed notification per day at 3 pm for 28 days. The results of the real-time data collected were reviewed during the three outpatient consultations by a psychiatrist using a dashboard that aggregated all of the patients' data into a user-friendly format.
Of the 11 patients in the study, 6 patients attended the 3 outpatient consultations with the psychiatrist and completed the HDRS at each consultation. We found a positive correlation between the HDRS score and the variables of self-esteem, guilt, and mood (Spearman correlation coefficient 0.57). Seven patients completed the daily EMAs for 28 days or longer, with an average response rate to the EMAs of 62.5% (175/280). Furthermore, we observed a positive correlation between the number of responses to EMAs and the duration of follow-up (Spearman correlation coefficient 0.63).
This preliminary study with a prolonged follow-up demonstrates significant patient compliance with the smartphone app. In addition, the self-assessments performed by patients seemed faithful to the standardized measurements performed by the psychiatrist. The results also suggest that for some patients it is more convenient to use the smartphone app than to attend outpatient consultations.
生态瞬时评估（EMA）是管理精神疾病尤其是抑郁症的一种很有前景的工具。它能对症状进行实时评估，并能更早地发现复发或治疗效果。智能手机在现代社会的普及为EMA提供了新的大规模支持。
本研究的主要目的有两个：（1）根据完成的EMA数量评估患者对EMA智能手机应用程序的依从性，（2）通过自尊/内疚/情绪变量与汉密尔顿抑郁量表（HDRS）评分之间的相关性来估计EMA的外部效度。
法国巴黎皮提耶-萨尔佩特里埃医院的11名患者通过智能手机应用程序进行了28天的监测。参与研究的每位患者有两种评估方式：（1）在三个不同时间点（第1天、第15天和第28天）与精神科医生进行三次门诊咨询，（2）使用EMA智能手机应用程序进行实时数据收集，每天下午3点有一次固定通知，持续28天。在三次门诊咨询期间，精神科医生使用一个仪表盘对收集的实时数据结果进行审查，该仪表盘将所有患者的数据汇总成一种用户友好的格式。
研究中的11名患者中，有6名患者与精神科医生进行了3次门诊咨询，并在每次咨询时完成了HDRS评估。我们发现HDRS评分与自尊、内疚和情绪变量之间存在正相关（斯皮尔曼相关系数为0.57）。7名患者完成了28天或更长时间的每日EMA，EMA的平均回复率为62.5%（175/280）。此外，我们观察到EMA回复次数与随访时间之间存在正相关（斯皮尔曼相关系数为0.63）。
这项随访时间延长的初步研究表明患者对智能手机应用程序有显著的依从性。此外，患者进行的自我评估似乎与精神科医生进行的标准化测量结果相符。结果还表明，对于一些患者来说，使用智能手机应用程序比参加门诊咨询更方便。
