Ecological momentary interventions for bipolar disorder: a systematic review and meta-analysis.

Background and objectives: Bipolar Disorders affect 2% of the world population and ranks as the sixth leading cause of disability. Barriers such as lack of insight and limited access to healthcare result in a significant disease burden. These barriers can be mitigated by technology-delivered interventions such as ecological momentary interventions, which provide personalized, real-time treatments based on ecological momentary assessments of relevant variables. This review aimed to assess the effectiveness of ecological momentary interventions in bipolar disorder.

Methods: We conducted searches across Medline, Scopus, CENTRAL, psychINFO and ProQuest without applying any filter through December 30, 2023. Two authors screened results to eliminate irrelevant and duplicate studies, and the remaining studies were independently reviewed. Data were extracted, transformed into a common rubric, and analyzed for treatment effects using Review Manager 5.

Findings: We analyzed 14 studies, encompassing 1776 patients with bipolar disorder. Interventions were mostly based on psychoeducation and cognitive behavioral therapy. EMI had small to moderate effects on quality of life (SMD = 0.24; 95% CI = 0.04-0.44, P = 0.02; I² = 47%), medication adherence (SMD = 0.21; 95% CI = 0.03-0.39, P = 0.02; I² = 0%), and affective episodes (HR = 0.75; 95% CI = 0.57-0.98, P = 0.04; I² = 0%).

Conclusion: Ecological momentary intervention is a novel area of research in behavioral science. The results of this systematic review based on the available literature suggest that these interventions could be beneficial for patients with bipolar disorder.