The user experience of ambulatory assessment and mood monitoring in depression: a systematic review & meta-synthesis

The preferences and opinions of individuals with depression will likely be fundamental for the success of mood monitoring interventions, or for ambulatory assessment approaches as methods of data collection. Concerns have been raised regarding negative psychological effects of repeated mood assessment. This systematic review and meta-synthesis of qualitative studies assessed the user experience of mood monitoring and ambulatory assessment procedures. This included: barriers and facilitators to use for people with depression and for clinicians, negative psychological effects and the intended purpose of use. Eight electronic databases were searched and mixed-methods studies were included. Qualitative studies were rated for risk of bias. Fourteen studies were identified. We identified seven overarching concepts: negative psychological effects, perceived effectiveness, difficulties in completing questionnaires, sharing with others, desired features, purpose of mood monitoring, and clinician barriers/facilitators. While many participants found the mood monitoring/ambulatory assessment therapeutic and positive, many participants reported negative consequences from ambulatory assessment/mood monitoring. Future protocols should monitor negative psychological effects, whether they are long-lasting and consider testing the incorporation of additional therapeutic elements to manage them. We report additional key concepts that are likely to improve the user experience, engagement, attrition, usability and acceptability of ambulatory assessment/mood monitoring protocols for people with depression.