Oomen Priscilla P, Simons Claudia J P, Broekmans-Madikrama Kim, Marcelis Machteld
Geestelijke Gezondheidszorg Eindhoven, Institute of Mental Health Care.
Psychiatr Rehabil J. 2024 Dec;47(4):329-338. doi: 10.1037/prj0000621. Epub 2024 Jul 25.
Personalized dose optimization is desirable to improve subjective well-being and support rehabilitation. Therefore, = 1 trials investigating tools to self-manage functional outcomes during dose optimization are necessary. The aim of this pilot study was to determine in two = 1 trials whether an experience sampling method (ESM) smartphone app could be used to monitor and detect changes in subjective well-being and psychotic experiences during and after dose reduction.
Two participants with a psychotic disorder in remission underwent gradual dose reduction under a longitudinal self-monitoring paradigm, accompanied by regular clinical monitoring by the attending physician. Subjective well-being was monitored with an (ESM) app through momentary affective experience (positive and negative affect) and physical well-being (tiredness, feeling unwell, and pain). Momentary psychotic experiences were assessed with four items. Time-series linear regression models were used to detect changes in reduction phases compared to baseline.
Whereas significant improvements in subjective well-being and psychotic experiences during dose reduction were detected in one participant, the opposite was demonstrated for the other participant, showing worsened subjective well-being and increased psychotic experiences in the reduction phase compared to baseline.
Self-monitoring with an ESM smartphone app offers a tool for detecting changes in subjective well-being and psychotic experiences during antipsychotic dose reduction. In this way, ESM may increase an individual's sense of control and empowerment. It may further facilitate dose optimization and shared decision-making at an individual level, which is required considering the high heterogeneity in psychotic disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
个性化剂量优化有助于改善主观幸福感并支持康复。因此，进行n = 1试验以研究在剂量优化过程中自我管理功能结果的工具很有必要。这项初步研究的目的是通过两项n = 1试验，确定一款经验取样法（ESM）智能手机应用程序是否可用于监测和检测剂量减少期间及之后主观幸福感和精神病体验的变化。
两名处于缓解期的精神病患者在纵向自我监测范式下逐渐减少剂量，同时主治医生进行定期临床监测。通过一款（ESM）应用程序，通过即时情感体验（积极和消极情绪）以及身体幸福感（疲劳、身体不适和疼痛）来监测主观幸福感。通过四个项目评估即时精神病体验。使用时间序列线性回归模型来检测与基线相比减少阶段的变化。
一名参与者在剂量减少期间主观幸福感和精神病体验有显著改善，而另一名参与者则相反，与基线相比，其在减少阶段主观幸福感恶化，精神病体验增加。
使用ESM智能手机应用程序进行自我监测为检测抗精神病药物剂量减少期间主观幸福感和精神病体验的变化提供了一种工具。通过这种方式，ESM可能会增强个体的控制感和自主权。它还可能进一步促进个体层面的剂量优化和共同决策，鉴于精神病性障碍的高度异质性，这是必要的。（PsycInfo数据库记录（c）2024美国心理学会，保留所有权利）
