Is your mood influenced when you monitor your mood using your smartphone?

Rationale

Mood can be assessed in the moment and place it is experienced, which is called ecological momentary assessment (EMA). EMA may be a valid method for assessing mood, and recently it has become possible to use smartphones to conduct EMA. EMA may not only measure, but also influence an individual’s mood. From a clinical perspective, this would be especially relevant among individuals who experience low mood, a depressive symptom. It is, however, unknown whether EMA has an effect on low mood, and if there is, in which direction.



Objectives

The primary objective is to investigate whether EMA of mood, self-administered by individuals who experience low mood, has an effect on retrospectively self-reported low mood over time. A secondary objective is a longitudinal analysis of EMA data.



Study design

This study is a randomised controlled trial among participants who experience low mood. The trial consists of three groups: group 1 self-administers EMA of mood, group 2 self-administers daily assessment of other variables (active placebo, see below), group 3 does neither (control). All groups receive a retrospective self-report questionnaire (CES-D) at baseline (T0), six weeks after baseline (T6) and 12 weeks after baseline (T12).



Study population

We aim to recruit 120 participants who experience low mood among the general population. Low mood is defined as a mild to moderate score on the PHQ-9 (total score 5 to 15).



Main study parameters/endpoints

The primary outcome measure is retrospectively self-reported mood, measured with the CES-D.

Mood monitoring using smartphones has no clinically relevant effect on low mood.

There are 3 time points:

T0 - Baseline assessment

T6 - Assessment at week 6

T12 - Assessment at week 12

It is unknown whether monitoring one's mood can be considered an intervention. That is what this study will find out. Nevertheless, we provide a description of the monitoring here. Participants in group 1 will install an application on their smartphones, which allows them to monitor their mood. Every day, the participant receives one notification at a random time point between ten o'clock in the morning and ten o'clock in the evening. This notification directs the participant to the question 'How is your mood right now?', which the participant can enter on a visual analogue scale from 1 (worst) to 10 (best). The notification remains accessible until the next notification is sent. The measurement will be time stamped, i.e. the system saves the exact time when the participant rates his/her mood (not when the notification was sent). During week 1 and week 12, the participant rates his/her mood 3 times a day in order to measure mood fluctuations during the day.

Participants in group 2 will also install an application on their smartphones, which works the same as the mood monitoring app, but presents the following question each day: “How energetic do you feel right now?”.

Participants in group 3 do not monitor anything. They complete online questionnaires, just as groups 1 and 2.