# How EMA can be used to assess Mood [[Article - Mood disorders in everyday life]] [[Article - Transdiagnostic Mobile Health - smartphone Intervention Reduces Depressive Symptoms in People With Mood and Psychotic Disorders]] - A recent meta-analysis of 18 randomized controlled trials (RCTs) of smartphone-based mental health interventions for depressive symptoms found that these treatments had positive effects in comparison with both active interventions and inactive control conditions. Therapeutic effects were found for those with self-reported mild to moderate depression but were not seen among those with diagnoses of major mood disorders [25]. [[FOCUS - Ben Zeev, Brenner, Begale, Mueser]] - "Through several iterative cycles of development and user feedback, we constructed a smartphone system that targets symptoms of psychosis, social functioning, mood problems, medication adherence, and sleep difficulties. We drew treatment content from an array of evidence-based interventions (ie, cognitive restructuring, behavioral tailoring, social skills training, illness management and recovery, anger management, behavioral activation, sleep hygiene), and adapted it so that it was suitable for delivery via smartphones" - p 1245 - "Over the course of 1 month, the FOCUS system prompted participants to complete an assessment Smartphone Treatment Trial 3 times daily, on one of each of the 3 treatment targets between the hours of 9 am and 1 pm, 1 and 5 pm, and 5 and 9 pm (exact times within those ranges were determined randomly daily by the system)" - p 1247 - "Once signaled by the prompting app (see figure  1), users can decide to engage or ignore the prompt. If they engage, the system will launch a brief assessment of their current status (eg, “How has your mood been today?”) with multiple choice touchscreen response options that appear below the question on the same screen. If the user endorses difficulties (eg, “Very bad. I’m very upset”) the system provides feedback (eg, “Looks like you could use some support. FOCUS is happy to help.”), followed by a more in-depth assessment (“Have you had any of these thoughts lately?”). Users’ responses determine the nature of the subsequent interventions they will receive (eg, see figure 2). Once they complete a sequence of screens, making selections as they progress and receiving interventions, the system signs off (“Thank you for using FOCUS. Have a nice day.”) until the next scheduled prompt." - p 1248 [[Daily mood monitoring of symptoms using smartphones in bipolar disorder - A pilot study]] [[Article - Prediction of impending mood episode recurrence using real-time digital phenotypes in major depression and bipolar disorders in South Korea - a prospective nationwide cohort study]] [[Article - A systematic review of momentary assessment designs for mood and anxiety symptoms]] - According to a systematic review, there is no consistent standards on how EMA should be designed. There is also measurement heterogeneity - "The methodological differences across these studies, while partially a reflection of the myriad of research questions in this area, has also meant that comparing results across studies is harder. For example, a 2012 review of EMA studies of Major Depressive Disorder (MDD) showed that the total duration of EMA data collection ranged from 3 to 42 days, with daily assessments occurring anywhere between 2 to 10 times (aan het Rot et al., 2012)." - "Though open science practices, such as providing supplemental materials with full lists of the items administered, are growing in popularity, these resources are provided inconsistently and, for older EMA studies, may not be available at all anymore (Trull and Ebner-Priemer, 2020). In addition to the measurement heterogeneity induced by the use of disparate items, this also creates additional barriers to replication." ## How Mood is associated with Schizophrenia Relapse [[On Prodrome and Relapse]] [[What's our conceptual framework]]