JMIR Publications

ABSTRACT

This study aims to: (1) evaluate the feasibility of collecting smartphone-based Ecological Momentary Assessment (EMA) data alongside activity and sleep tracking in adolescents with depression; (2) investigate the severity and variability of mood symptoms reported over time; and (3) explore the relationship between mood, activity, and sleep. Twenty-eight participants (16 with Major Depressive Disorder (MDD), 12 unaffected controls) completed twice-daily EMA check-ins over two weeks, complemented by continuous activity and sleep monitoring using FitBit devices. The study examined feasibility, usability of EMA app, symptom severity and variability, and relationships between mood, activity, and sleep. High compliance rates indicated the feasibility of smartphone-based EMA. MDD participants demonstrated greater symptom severity and variability compared to controls. Additionally, MDD cases exhibited more inconsistent sleep patterns, shorter total sleep times, and a higher frequency of naps. Activity levels, measured by steps per day, did not significantly differ between groups or correlate with mood variability. This study is one of the first to integrate smartphone-based EMA and wearable activity tracking in adolescents with depression. The findings highlight the potential of these technologies to capture real-time data, providing valuable insights into the dynamic nature of depressive symptoms. Future studies should explore EMA and activity tracking methods in larger, more diverse populations to validate these findings. Clinically, the feasibility of EMA and activity tracking suggests these methods could enhance routine assessments and inform personalized interventions by accounting for individual symptom fluctuations and external factors such as environmental stressors and social interactions