Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 22, 2022
Date Accepted: Mar 15, 2023
Adherence to Experience Sampling Method (ESM) among Patients with Schizophrenia Spectrum Disorder and Unaffected Controls: an Observational Study from the Multicentric DiAPAson Project
ABSTRACT
Background:
The Experience Sampling Method (ESM) is a valid method of remotely recording activities, but the predictors of adherence to ESM in patients with Schizophrenia Spectrum Disorders (SSD) are not known.
Objective:
The aim of this study was to compare the adherence to ESM in individuals with SSD and unaffected controls, investigate their patterns, and report on the predictors of adherence.
Methods:
131 patients with SSD (74 in residential facilities and 57 outpatients) and 115 unaffected controls were recruited at ten different centres in Italy, as part of the DiAPAson project. Demographic information, symptom severity, disability level, and level of function were recorded for the clinical sample. Participants were evaluated for daily time use and mood through a smartphone-based ESM 8 times a day for seven days. Adherence was measured by the responses to ESM notifications. Differences were analysed using chi-squared, ANOVA, Kruskall-Wallis and Friedman’s tests, and a logistic regression model.
Results:
Patients with SSD had a lower rate of adherence to ESM when compared to the control group (p <.001), independent of time slot, day of monitoring or the day of the week. The lowest adherence rate was in the late evening (20:00 - 24:00) time slot and days 6-7 of the study for both patients and controls. Higher adherence rate (i.e. ≥ 70%) was predicted by higher collaboration skills (OR= 2.952; p .046) and self-esteem (OR= 3.394; p .029), and lower positive symptoms severity (OR= .835; p .036).
Conclusions:
This study provides important information to guide protocols for future studies employing ESM, including the selection and preparation of participants and the training of clinicians and researchers Clinical Trial: -
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