Digital measures of activity and motivation impact depression and anxiety in the real world.

Mood and anxiety disorders are highly comorbid, with symptom severity varying over time. Individuals with and without these disorders completed 30-days of ecological momentary assessment (EMAs) of depression, anxiety and distress, developed based on the established Mood and Anxiety Symptom Questionnaire (MASQ). These electronic MASQ (eMASQ) EMAs were collected alongside novel intrinsic and extrinsic motivation EMAs, and physical/digital activity measures (steps/screentime) across N = 70-101 participants. Each eMASQ-EMA significantly related to its corresponding MASQ measure. Extrinsic and intrinsic motivation negatively related to each eMASQ-EMA and had the greatest influence on patients' overall symptom profile. Physical, but not digital activity, was negatively associated with concurrent and 1-week lagged anxiety and depression, highlighting the temporally delayed benefits of physical activity on depression and anxiety symptoms in psychiatric groups. Collectively, this study suggests cognitive constructs related to drive and physical activity, may be useful in predicting continuous and transient psychiatric symptoms in the real-world.