title: Testing an mHealth momentary assessment Routine Outcome Monitoring application: a focus on restoration of daily life positive mood states.
abstract: BACKGROUND
  Routine Outcome Monitoring (ROM) is used as a means to enrich the process of treatment with feedback on patient outcomes, facilitating patient involvement and shared decision making. While traditional ROM measures focus on retrospective accounts of symptoms, novel mHealth technology makes it possible to collect real life, in-the-moment ambulatory data that allow for an ecologically valid assessment of personalized and contextualized emotional and behavioural adjustment in the flow daily life (mROM).
  
  
  METHODS
  In a sample of 34 patients with major depressive disorder, treated with antidepressants, the combined effect of treatment and natural course was examined over a period of 18 weeks with Ecological Momentary Assessment (EMA). EMA consisted of repeated, within-subject, mini-measurements of experience (eg positive affect, negative affect, medication side effects) and context (eg stressors, situations, activities) at 10 unselected semi-random moments per day, for a period of six days, repeated three times over the 18-week period (baseline, week 6 and week 18).
  
  
  RESULTS
  EMA measures of emotional and behavioural adjustment were sensitive to the effects of treatment and natural course over the 18-week period, particularly EMA measures focussing on positive mood states and the ability to use natural rewards (impact of positive events on positive mood states), with standardized effect sizes of 0.4-0.5. EMA measures of activities, social interaction, stress-sensitivity and negative mood states were also sensitive to change over time.
  
  
  CONCLUSIONS
  This study supports the use of mROM as a means to involve the patient in the process of needs assessment and treatment. EMA data are meaningful to the patient, as they reflect daily life circumstances. Assessment of treatment response with mROM data allows for an interpretation of the effect of treatment at the level of daily life emotional and social adjustment--as an index of health, obviating the need for an exclusive focus on traditional measures of 'sickness'.
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, South Limburg Mental Health and Teaching Network, Maastricht, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom.
authors.forename: Jim
authors.initials: J
authors.lastname: van Os
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, South Limburg Mental Health and Teaching Network, Maastricht, The Netherlands.
authors.forename: Philippe
authors.initials: P
authors.lastname: Delespaul
authors.affiliation: Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Daniela
authors.initials: D
authors.lastname: Barge
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, South Limburg Mental Health and Teaching Network, Maastricht, The Netherlands; Psychiatric Centre GGZ Centraal, Amersfoort, The Netherlands.
authors.forename: Roberto P
authors.initials: RP
authors.lastname: Bakker
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003199:Computer Systems; D003865:Major Depressive Disorder / Q000188:drug therapy*; D006801:Humans; D007099:Imipramine; D008875:Middle Aged; D009426:Netherlands; D063868:Patient Outcome Assessment; D010358:Patient Participation / Q000379:methods*; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents; D007099:Imipramine