A therapeutic application of the experience sampling method in the treatment of depression: a randomized controlled trial.
In depression, the ability to experience daily life positive affect predicts recovery and reduces relapse rates. Interventions based on the experience sampling method (ESM-I) are ideally suited to provide insight in personal, contextualized patterns of positive affect. The aim of this study was to examine whether add-on ESM-derived feedback on personalized patterns of positive affect is feasible and useful to patients, and results in a reduction of depressive symptomatology. Depressed outpatients (n=102) receiving pharmacological treatment participated in a randomized controlled trial with three arms: an experimental group receiving add-on ESM-derived feedback, a pseudo-experimental group participating in ESM but receiving no feedback, and a control group. The experimental group participated in an ESM procedure (three days per week over a 6-week period) using a palmtop. This group received weekly standardized feedback on personalized patterns of positive affect. Hamilton Depression Rating Scale - 17 (HDRS) and Inventory of Depressive Symptoms (IDS) scores were obtained before and after the intervention. During a 6-month follow-up period, five HDRS and IDS assessments were completed. Add-on ESM-derived feedback resulted in a significant and clinically relevant stronger decrease in HDRS score relative to the control group (p<0.01; -5.5 point reduction in HDRS at 6 months). Compared to the pseudo-experimental group, a clinically relevant decrease in HDRS score was apparent at 6 months (B=-3.6, p=0.053). Self-reported depressive complaints (IDS) yielded the same pattern over time. The use of ESM-I was deemed acceptable and the provided feedback easy to understand. Patients attempted to apply suggestions from ESM-derived feedback to daily life. These data suggest that the efficacy of traditional passive pharmacological approach to treatment of major depression can be enhanced by using person-tailored daily life information regarding positive affect.
GGzE, Institute of Mental Health Care Eindhoven and the Kempen, P.O. Box 909, 5600 AX Eindhoven, The Netherlands; Department of Psychiatry and Psychology, Maastricht University Medical Centre, European Graduate School of Neuroscience, SEARCH, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Ingrid
I
Kramer
Claudia J P
CJ
Simons
Jessica A
JA
Hartmann
Claudia
C
Menne-Lothmann
Wolfgang
W
Viechtbauer
Frenk
F
Peeters
Koen
K
Schruers
Alex L
AL
van Bemmel
Inez
I
Myin-Germeys
Philippe
P
Delespaul
Jim
J
van Os
Marieke
M
Wichers
Ecological momentary assessment; depressive disorder; experience sampling method; intervention study; positive affect; psychological feedback