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Background: Ambulatory assessment and mood monitoring are different methods that can use novel technology to deliver a more efficient, flexible and usable method of clinical outcome assessment compared to established measures of behavior and mood. Concerns have been raised around attrition in and adherence to these new protocols, particularly over the medium to long term in people with mood disorders. Objective: This systematic review and meta-analysis assessed attrition in and adherence to active and passive ambulatory assessment and mood monitoring protocols in people with bipolar disorder and #depression over the medium and long term. Methods: Randomised controlled trials and non-randomised studies were identified and rated for risk of bias. Adherence and attrition data were pooled to calculate effect sizes. We analysed specific factors that we hypothesized a priori could affect the prevalence of attrition and adherence by means of subgroup meta-analysis and/or meta-regression modelling. Results: 77 mood tracking/ambulatory assessment studies including 17,123 participants were evaluated. Pooled adherence(95%CI) was 0.64 ((0.59, 0.70), p-value:

Background: Mood monitoring is widely used by people with #depression and bipolar disorder (BD) to prevent relapse and improve insight into their condition but it is unclear if these interventions have an impact on symptoms and for whom. As the capacity for passive mood monitoring increases it is vital to improve our understanding of frequent mood assessment. Objective: This systematic review and meta-analysis assessed the effect of mood monitoring interventions in people with #depression and BD to decrease relapse risk and symptoms of #depression and mania. Methods: We conducted a systematic review and meta-analysis (PROSPERO: CRD42023396473) and reported results according to PRISMA guidelines. RCTs with clinically important follow up periods were identified via multiple database searching and rated for risk of bias using the Cochrane Risk of Bias tool. The primary outcomes were symptoms of #depression and mania. Available data was pooled to calculate standardized mean differences for the primary outcomes: severity of #depression, bipolar #depression and mania/hypomania. Results: We included 8 trials of 1,230 participants and 6 different mood monitoring protocols. In BD, meta-analysis found a small but not statistically significant effect of mood monitoring interventions on decreasing mania symptoms (6 comparisons, n = 873, SMD: -0.16 (-0.34 to 0.01), p= 0.06) and no effect on bipolar #depression (6 comparisons, n = 873, SMD: -0.08 (-0.31 to 0.15), p= 0.02). In #depression, we found a small effect in decreasing symptoms of #depression of borderline statistical significance at 12 months (2 comparisons, n = 262, SMD: -0.25 (-0.49, 0.00), p= 0.05) but not at 6 months (2 comparisons, n = 268, SMD: -0.21 (-0.54, 0.12), p= 0.21). There was an absence of evidence on the effect of mood monitoring on decreased relapse rates or readmission rates. Studies had low risk of bias. There was no evidence on mood monitoring through ecological momentary assessment. Conclusions: Overall mood monitoring interventions do not increase or decrease mood symptoms in people with bipolar disorder nor is there robust evidence of such effects in people with unipolar #depression. Further research is merited on different forms of mood monitoring and to determine under what circumstances mood monitoring might have beneficial or adverse effects. These results initially suggest that ambulatory assessment does not induce large placebo effects or significantly negatively/positively effect mood and thus that mood monitoring may be an #Appropriate outcome measure for research or for clinical practice.

Background: Mood monitoring and ambulatory assessment offers improvements in measuring mood and behaviour for #MentalHealth research and clinical practice. However, concerns about adverse effects and usability may hinder its implementation. Objective: This systematic review and meta-analysis assessed the prevalence of adverse events, barriers to use, facilitators to use and suggestions for improvement in quantitative mood monitoring studies in people with #depression and bipolar disorder. Methods: We conducted a systematic review and meta-analysis (PROSPERO: CRD42023396473) of 77 quantitative studies using mood monitoring/ambulatory assessment in #depression and bipolar disorder, assessing adverse events, barriers and facilitators to use, and suggestions for improvement. Adverse events data was pooled to identify prevalence. Results: Of 77 studies, 15 reported adverse events and 20 reported usability issues. Pooled prevalence (95%CI, P-value) of adverse events was 0.04 (0.03, 0.06; p