Ecological momentary assessment as a measurement tool in depression trials

• Published in: Journal of psychiatric research 2021-04, Vol.136, p.256-264
• Main Authors: Targum, Steven D., Sauder, Colin, Evans, Miriam, Saber, John N., Harvey, Philip D.
• Format: Article
• Language: English
• Subjects: Antidepressive Agents - therapeutic use; Depression; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - drug therapy; Ecological Momentary Assessment; Experience sampling; Humans; MDD; Self Report; Subject selection; Symptom fluctuation
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2021.02.012

We used ecological momentary assessment (EMA) to track symptoms during a clinical trial. Thirty-six participants with major depressive disorder (MDD) and MADRS scores ≥20 were enrolled in a nonrandomized 6-week open-label trial of commercially available antidepressants. Twice daily, a mobile device prompted participants to self-report the 6 items of the HamD6 sub-scale derived from the Hamilton rating scale for depression (HamD17). Morning EMA reports asked “how do you feel now” whereas evening reports gathered a full-day impression. Clinicians who were blinded to the EMA data rated the MADRS, HamD17 and HamD6 at screen, baseline and weeks 2,4, and 6. Hierarchical linear modeling (HLM) examined the course of the EMA assessments and convergence between EMA scores and clinician ratings. HLM analyses revealed strong correlations between AM and PM EMA derived HamD6 scores and revealed significant improvements over time. EMA improvements were significantly correlated with the clinician rated HamD6 scores at endpoint and predicted clinician rated HamD6 score changes from baseline to endpoint (p