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Accepted for/Published in: JMIR Formative Research

Date Submitted: Mar 20, 2025
Date Accepted: Dec 11, 2025

The final, peer-reviewed published version of this preprint can be found here:

Demographic and Clinical Characteristics Influencing Ecological Momentary Assessment Compliance in Individuals With Bipolar Disorder: Observational Study

Yin L, Li J, Li M, Hou X, Song J, Li X, Tong Y, Zhou X, Yuan L, Yin H, Xu G

Demographic and Clinical Characteristics Influencing Ecological Momentary Assessment Compliance in Individuals With Bipolar Disorder: Observational Study

JMIR Form Res 2026;10:e74223

DOI: 10.2196/74223

PMID: 41499768

PMCID: 12824568

Demographic and Clinical Characteristics Influencing Electronic Ecological Momentary Assessment (EMA) Compliance in Chinese Individuals with Bipolar Disorder: An Observational Study

  • Linru Yin; 
  • Jinhao Li; 
  • Minghui Li; 
  • Xiaofei Hou; 
  • Jianan Song; 
  • Xinyan Li; 
  • Yue Tong; 
  • Xinyue Zhou; 
  • Lidan Yuan; 
  • Huifang Yin; 
  • Guangming Xu

ABSTRACT

Background:

The application of ecological momentary assessment (EMA) technology in mental health assessment is well constructed. Reliable assessment of symptoms and disease characteristics requires high-density multi-level data, which means that adequate compliance is essential to the effective conduct of EMA study.

Objective:

The purpose of this study is to understand the compliance rate of EMA in Chinese individuals with bipolar disorder and the demographic and clinical characteristics associated with compliance.

Methods:

One hundred adults (63 females) diagnosed with bipolar disorder in different mood states (29 with depressive episode, 17with (hypo)mania episode, and 54 with euthymic state were invited to self-monitor via the WeChat mini-program "Xunkang Assessment System" three times per day for two weeks. The compliance rate is calculated as the percentage of completed questionnaires out of the total required over two weeks. Multivariate ordinal logistic regressions were used to explore the factors associated with compliance rate.

Results:

The median compliance rate was 75.0% (IQR: 35.7%-90.4%). No significant differences were observed among bipolar patients in different mood states (P=0.15). Multivariate ordinal logistic regression showed higher BRMS scores and lower FAST scores as significant predictors of better adherence in bipolar patients (BRMS: B=0.11, P=0.03; FAST: B=-0.06, P=0.01).

Conclusions:

It is possible to monitor Chinese patients with bipolar disorder in different mood states using EMA for two weeks period. However, some factors related to compliance rate such as manic symptoms and functional impairment should be considered when using EMA.


 Citation

Please cite as:

Yin L, Li J, Li M, Hou X, Song J, Li X, Tong Y, Zhou X, Yuan L, Yin H, Xu G

Demographic and Clinical Characteristics Influencing Ecological Momentary Assessment Compliance in Individuals With Bipolar Disorder: Observational Study

JMIR Form Res 2026;10:e74223

DOI: 10.2196/74223

PMID: 41499768

PMCID: 12824568

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