Prospective interepisodal mood monitoring in patients with affective disorders: a feasibility study

Objectives: Our primary objective was to assess the feasibility of interepisodal telephonic mood monitoring in patients with affective disorders in a low-resource setting. Secondary objectives included gathering data on longitudinal mood trajectories and assessing patient acceptance of mood monitoring. Methods: Inpatients with a primary mood or anxiety disorder were recruited predischarge. Assessment at intake included demographic information, the Life Events Checklist, and the Childhood Trauma Questionnaire. Participants telephonically completed the Altman Self-Rating Mania Scale (ASRM) and Quick Inventory of Depressive Symptomatology (QIDS), weekly, for 26 weeks. Units of alcohol consumed and life events were recorded. Semi-structured interviews were conducted midway through the mood monitoring protocol. Results: Of the 61 eligible participants (77% female; mean age = 35.3 years), 28 completed 26 weeks of telephonic mood monitoring. Thirty-three participants (54.1%) withdrew prematurely or were lost to follow-up. Males were more likely to terminate study participation prematurely. Despite the significant decline in depression scores over 26 weeks, participants endorsed persistent mild-to-moderate depressive symptoms. Statistically, participants who were married/in a relationship had higher mean depression scores throughout the study compared to participants who were single. Throughout the study, ASRM scores were not indicative of significant mania. Suicidality (as measured by QIDS item 12) was highest at Week 3 and Week 12 postdischarge for those who completed 26 weeks of monitoring. Conclusion: Despite the high attrition rate, interepisodal telephonic mood monitoring was deemed to be feasible and it can provide useful information to track progress, encourage medication adherence, and manage early warning signs of relapse. Further research is required to determine the benefit of weekly mood monitoring on mood fluctuations and to examine strategies that enhance retention.