JMIR Publications

ABSTRACT

Background:

Ambulatory assessment and active and passive monitoring all offer a real-time, flexible approach to assessing mood and behavior in mood disorders. Despite its potential, concerns remain regarding the performance, usability, adherence, and potential safety of these tools.

Objective:

This review synthesizes findings from seven systematic reviews, integrating quantitative and qualitative data from randomized trials, observational studies, and user experience research to evaluate performance, feasibility, acceptability, and clinical impact of ambulatory assessment and mood monitoring in people with depression and bipolar disorder.

Methods:

Systematic review and meta-analysis for quantitative data, with meta-synthesis for qualitative data. Eight electronic databases were searched and mixed-methods studies were included. Studies were assessed for risk of bias. PROSPERO: CRD42023396473. Results were checked for coherence and recommendations were made by individuals with lived experience, methodologists and psychiatrists. GRADE was used to assess the quality and strength of the evidence.

Results:

The 111 included studies included 19,945 participants and used 69 different ambulatory assessment protocols/mood monitoring interventions. Key barriers to implementation were identified across performance inconsistency, adverse effects, and user disengagement. Evidence-based recommendations are offered to guide future clinical and research applications.

Conclusions:

Ambulatory assessment and mood monitoring hold promise in research and in clinical practice, yet their implementation requires more rigorous evaluation, greater personalization, and responsible, user-centered design. Crucially these measures can add granularity and confirmation but none are robust enough yet to replace current outcomes.