Smartphone Ecological Momentary Assessment and Wearable Activity Tracking in Pediatric Depression: Cohort Study

Area of Science:

• Mental Health
• Digital Health
• Adolescent Psychology

Background:

• Adolescent depression is a significant public health issue with symptom variability.
• Ecological Momentary Assessment (EMA) improves understanding of Major Depressive Disorder (MDD) by reducing recall bias.
• EMA offers insights into fluctuating depression, aiding personalized interventions.

Purpose of the Study:

• Evaluate feasibility of smartphone-based EMA and activity tracking in adolescents with depression.
• Investigate mood symptom severity and variability over time.
• Explore relationships between mood, activity, and sleep.

Main Methods:

• 36 participants (23 with MDD, 13 controls) used smartphones for twice-daily EMA and FitBit for activity/sleep tracking over 2 weeks.
• Assessed feasibility, app usability, symptom severity/variability, and mood-activity-sleep relationships.
• Linear mixed-effects regression analyzed data.

Main Results:

• High compliance (91.57%) confirms feasibility of EMA and wearable tracking.
• MDD participants showed greater symptom severity and variability, worse morning mood, and more inconsistent sleep.
• Life stress predicted more severe EMA scores; activity levels did not significantly predict mood.

Conclusions:

• Integrating smartphone EMA with wearable tracking is feasible for adolescents with depression.
• EMA data reveal dynamic symptom patterns linked to sleep and stress.
• This approach can enhance assessments and inform personalized interventions for depression.