Monitoring momentary subjective well-being and psychotic experiences during antipsychotic dose reduction: Two single-case time series experience sampling method pilot study.
Priscilla P Oomen, Claudia J P Simons, Kim Broekmans-Madikrama, Machteld Marcelis
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引用次数: 0
Abstract
Objective: Personalized dose optimization is desirable to improve subjective well-being and support rehabilitation. Therefore, N = 1 trials investigating tools to self-manage functional outcomes during dose optimization are necessary. The aim of this pilot study was to determine in two N = 1 trials whether an experience sampling method (ESM) smartphone app could be used to monitor and detect changes in subjective well-being and psychotic experiences during and after dose reduction.
Method: Two participants with a psychotic disorder in remission underwent gradual dose reduction under a longitudinal self-monitoring paradigm, accompanied by regular clinical monitoring by the attending physician. Subjective well-being was monitored with an (ESM) app through momentary affective experience (positive and negative affect) and physical well-being (tiredness, feeling unwell, and pain). Momentary psychotic experiences were assessed with four items. Time-series linear regression models were used to detect changes in reduction phases compared to baseline.
Results: Whereas significant improvements in subjective well-being and psychotic experiences during dose reduction were detected in one participant, the opposite was demonstrated for the other participant, showing worsened subjective well-being and increased psychotic experiences in the reduction phase compared to baseline.
Conclusions and implications for practice: Self-monitoring with an ESM smartphone app offers a tool for detecting changes in subjective well-being and psychotic experiences during antipsychotic dose reduction. In this way, ESM may increase an individual's sense of control and empowerment. It may further facilitate dose optimization and shared decision-making at an individual level, which is required considering the high heterogeneity in psychotic disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
目的：个性化剂量优化是改善主观幸福感和支持康复的理想选择。因此，有必要进行 N = 1 试验，研究在剂量优化期间自我管理功能结果的工具。本试验研究旨在通过两项 N = 1 试验确定是否可以使用经验取样法（ESM）智能手机应用程序来监测和检测减量期间和减量后主观幸福感和精神病体验的变化：方法：两名患有缓解期精神病的参与者在主治医生的定期临床监测下，在纵向自我监测范式下逐渐减少剂量。主观幸福感通过（ESM）应用程序进行监测，包括瞬间情感体验（积极和消极情感）和身体幸福感（疲倦、不适和疼痛）。瞬时精神病体验通过四个项目进行评估。采用时间序列线性回归模型来检测与基线相比在减轻阶段的变化：结果：一名受试者在减量期间的主观幸福感和精神病性体验均有明显改善，而另一名受试者的情况恰恰相反，与基线相比，减量阶段的主观幸福感恶化，精神病性体验增加：使用ESM智能手机应用程序进行自我监测，为检测抗精神病药物减量期间主观幸福感和精神病性体验的变化提供了一种工具。通过这种方式，ESM 可以增强个人的控制感和能力。考虑到精神障碍的高度异质性，它可以进一步促进剂量优化和个体层面的共同决策。(PsycInfo Database Record (c) 2024 APA，保留所有权利）。
期刊介绍：
The Psychiatric Rehabilitation Journal is sponsored by the Center for Psychiatric Rehabilitation, at Boston University"s Sargent College of Health and Rehabilitation Sciences and by the US Psychiatric Rehabilitation Association (USPRA) . The mission of the Psychiatric Rehabilitation Journal is to promote the development of new knowledge related to psychiatric rehabilitation and recovery of persons with serious mental illnesses.
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