title: Effects of momentary self-monitoring on empowerment in a randomized controlled trial in patients with depression.
abstract: BACKGROUND
  Interventions based on the experience sampling method (ESM) are ideally suited to provide insight into personal, contextualized affective patterns in the flow of daily life. Recently, we showed that an ESM-intervention focusing on positive affect was associated with a decrease in symptoms in patients with depression. The aim of the present study was to examine whether ESM-intervention increased patient empowerment.
  
  
  METHODS
  Depressed out-patients (n=102) receiving psychopharmacological treatment who had participated in a randomized controlled trial with three arms: (i) an experimental group receiving six weeks of ESM self-monitoring combined with weekly feedback sessions, (ii) a pseudo-experimental group participating in six weeks of ESM self-monitoring without feedback, and (iii) a control group (treatment as usual only). Patients were recruited in the Netherlands between January 2010 and February 2012. Self-report empowerment scores were obtained pre- and post-intervention.
  
  
  RESULTS
  There was an effect of group×assessment period, indicating that the experimental (B=7.26, P=0.061, d=0.44, statistically imprecise) and pseudo-experimental group (B=11.19, P=0.003, d=0.76) increased more in reported empowerment compared to the control group. In the pseudo-experimental group, 29% of the participants showed a statistically reliable increase in empowerment score and 0% reliable decrease compared to 17% reliable increase and 21% reliable decrease in the control group. The experimental group showed 19% reliable increase and 4% reliable decrease.
  
  
  CONCLUSIONS
  These findings tentatively suggest that self-monitoring to complement standard antidepressant treatment may increase patients' feelings of empowerment. Further research is necessary to investigate long-term empowering effects of self-monitoring in combination with person-tailored feedback.
authors.affiliation: GGzE, Institute of Mental Health Care Eindhoven and De 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. Electronic address: c.simons@maastrichtuniversity.nl.
authors.forename: C J P
authors.initials: CJ
authors.lastname: Simons
authors.affiliation: GGzE, Institute of Mental Health Care Eindhoven and De 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; Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia.
authors.forename: J A
authors.initials: JA
authors.lastname: Hartmann
authors.affiliation: GGzE, Institute of Mental Health Care Eindhoven and De 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.
authors.forename: I
authors.initials: I
authors.lastname: Kramer
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, European Graduate School of Neuroscience, SEARCH, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Menne-Lothmann
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, European Graduate School of Neuroscience, SEARCH, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Höhn
authors.affiliation: GGzE, Institute of Mental Health Care Eindhoven and De 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.
authors.forename: A L
authors.initials: AL
authors.lastname: van Bemmel
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, European Graduate School of Neuroscience, SEARCH, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: Myin-Germeys
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, European Graduate School of Neuroscience, SEARCH, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Mondriaan Mental Health Trust, South Limburg, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Delespaul
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, European Graduate School of Neuroscience, SEARCH, P.O. Box 616, 6200 MD Maastricht, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, UK.
authors.forename: J
authors.initials: J
authors.lastname: van Os
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, European Graduate School of Neuroscience, SEARCH, P.O. Box 616, 6200 MD Maastricht, The Netherlands; University Medical Centre Groningen, Faculty of Medical Sciences, Groningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Wichers
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D017060:Patient Satisfaction; D011209:Power, Psychological; D011340:Problem Solving; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D055815:Young Adult
keywords: Depressive disorder; Ecological momentary assessment; Empowerment; Intervention study; Personalized feedback; Self-monitoring