Ecological momentary assessment as a clinical tool in psychiatry:promises, pitfalls, and possibilities

Achtergrond: Ecological momentary assessment (EMA) is een veelbelovende methode om meer inzicht te krijgen in het dagelijks leven van mensen met psychische problemen. Met EMA houden patiënten meermaals per dag hun symptomen, emoties, (sociale) activiteiten en gebeurtenissen bij. Door statistische methodieken, zoals netwerkanalyse, zou EMA-feedback nieuwe inzichten kunnen opleveren in de psychiatrische zorg.Doel: De belofte, valkuilen en mogelijkheden van EMA en netwerkanalyse voor de psychiatrische zorg onderzoeken.Methode: We gebruikten empirische netwerkstudies, reviews en kwalitatief onderzoek om de stand van onderzoek en de perspectieven van patiënten en behandelaars op EMA en netwerkanalyse in kaart te brengen. Daarnaast bespreken we een studie waarbij 20 patiënten met een bipolaire stoornis 4 maanden lang 5 maal per dag EMA-dagboeken invulden binnen hun behandeling.Resultaten: Studies naar netwerkanalyse lieten inconsistente bevindingen zien. Kwalitatief onderzoek wees uit dat patiënten met bipolaire stoornis en hun behandelaars de meerwaarde van EMA voor de zorg zien, met name in het versterken van inzicht en eigen regie. Tegelijkertijd vonden sommigen EMA belastend. Integratie van EMA in de zorg vereist personalisatie en goede aansluiting met bestaande behandelmethoden.Conclusie: EMA heeft toegevoegde waarde voor de psychiatrische zorg, mits het zorgvuldig ingezet wordt.BACKGROUND: Ecological momentary assessment (EMA) is a promising method to gain insight into the daily lives of people with mental disorders. EMA can be used to monitor mood, symptoms, and experiences multiple times per day. Using advanced statistical methods, such as network analysis, as EMA feedback might result in novel insights that are relevant to psychiatric care. AIM: To investigate the promise, pitfalls, and possibilities of EMA and network analysis for psychiatric care. METHOD: Empirical network studies, reviews, and qualitative research were employed to investigate the state of research and the perspectives of patients and clinicians on EMA and network analysis. Furthermore, an empirical study will be discussed, in which twenty patients with bipolar disorders completed five EMA diaries per day for four months within treatment. RESULTS: Studies using network analysis demonstrated conflicting results. Qualitative research indicated that bipolar patients and clinicians are aware of the added benefit of EMA for psychiatric care, especially for improving insight and self-management. At the same time, EMA was seen as burdensome. Personalization and integration with existing treatment protocols emerged as necessary requirements for adequate implementation of EMA in psychiatric care. CONCLUSION: EMA can have added value for psychiatric care, provided it is adequately implemented. BACKGROUND: Ecological momentary assessment (EMA) is a promising method to gain insight into the daily lives of people with mental disorders. EMA can be used to monitor mood, symptoms, and experiences multiple times per day. Using advanced statistical methods, such as network analysis, as EMA feedback might result in novel insights that are relevant to psychiatric care. AIM: To investigate the promise, pitfalls, and possibilities of EMA and network analysis for psychiatric care. METHOD: Empirical network studies, reviews, and qualitative research were employed to investigate the state of research and the perspectives of patients and clinicians on EMA and network analysis. Furthermore, an empirical study will be discussed, in which twenty patients with bipolar disorders completed five EMA diaries per day for four months within treatment. RESULTS: Studies using network analysis demonstrated conflicting results. Qualitative research indicated that bipolar patients and clinicians are aware of the added benefit of EMA for psychiatric care, especially for improving insight and self-management. At the same time, EMA was seen as burdensome. Personalization and integration with existing treatment protocols emerged as necessary requirements for adequate implementation of EMA in psychiatric care. CONCLUSION: EMA can have added value for psychiatric care, provided it is adequately implemented.