title: Ecological Momentary Assessment and Smartphone Application Intervention in Adolescents with Substance Use and Comorbid Severe Psychiatric Disorders: Study Protocol.
abstract: BACKGROUND
  Substance use disorders (SUDs) are highly prevalent among inpatient adolescents with psychiatric disorders. In this population, substance use and other psychiatric outcomes can reinforce one another. Despite the need for integrated interventions in youths with dual diagnoses, few specific instruments are available. App-based technologies have shown promising results to help reduce substance use in adolescents, but their applicability in youths with associated severe psychiatric disorders is poorly documented. We aim to evaluate the feasibility of an ecological momentary assessment (EMA) intervention for all substance users, and of a smartphone application for cannabis users (Stop-Cannabis), for outpatient treatment after hospital discharge.
  
  
  METHODS
  All inpatient adolescents with psychiatric disorders hospitalized between 2016 and 2018 in a university hospital will be systematically screened for SUD and, if positive, will be assessed by an independent specialist addiction team. Participants with confirmed SUDs will be invited and helped to download an EMA app and, if required, the Stop-Cannabis app, the week preceding hospital discharge. Information about the acceptability and use of both apps and the validity of EMA data in comparison to clinical assessments will be assessed after 6 months and 1 year.
  
  
  CONCLUSIONS
  This research has been designed to raise specific issues for consideration regarding the sequence between substance use, contextual factors, and other psychiatric symptoms among adolescents with comorbid severe psychiatric disorders. A better understanding of the mechanisms involved will inform the development of integrated treatment for dual disorders at that age.
  
  
  BACKGROUND
  The study has already been approved and granted. Dissemination will include presentations at international congresses as well as publications in peer-reviewed journals.
  
  
  BACKGROUND
  European Clinical Trials Database: Number 2016-001999-30.
authors.affiliation: Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpêtrière , Paris , France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Benarous
authors.affiliation: Department of Addiction, Hôpital Pitié-Salpêtrière , Paris , France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Edel
authors.affiliation: Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpêtrière , Paris , France.
authors.forename: Angèle
authors.initials: A
authors.lastname: Consoli
authors.affiliation: Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpêtrière , Paris , France.
authors.forename: Julie
authors.initials: J
authors.lastname: Brunelle
authors.affiliation: Institute of Global Health, University of Geneva , Geneva , Switzerland.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Etter
authors.affiliation: Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpêtrière, Paris, France; UMR 7222, Institute of Intelligent Systems and Robotics, Université Pierre et Marie Curie, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Cohen
authors.affiliation: Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland; Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Khazaal
keywords: adolescents; cannabis addiction; ecological momentary assessment; ecological momentary intervention; mHealth app; prevention; smartphone app; substance use disorder