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Use of Ecological Momentary Assessment to Study Suicidal Thoughts and Behavior: a Systematic Review

  • Mood Disorders (E Baca-Garcia, Section Editor)
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Abstract

Purpose of Review

Ecological momentary assessment (EMA) is a recently introduced approach to patient evaluation that consists of asking patients questions in real time and in their usual habitat. This method seeks to contribute to suicide prevention by providing psychiatrists with detailed information about suicidal thoughts and behavior, how these fluctuate over short periods of time, and the short-term risk factors presented by patients. We conducted a systematic review of published research using EMA to study suicidal thoughts and behavior.

Recent Findings

Several systematic reviews of EMA in mental health have been conducted to date, and the literature contains numerous theoretical papers and compilations on EMA and suicide phenomena. To date, however, no systematic reviews have explored the use of this tool to study suicidal thoughts and behavior.

Summary

We performed a systematic review of five databases (i.e., PubMed, Embase, Scopus, Web of Science, and PsycINFO) to identify studies on EMA and suicidal thoughts and behavior. An initial search revealed 544 articles. Following the study selection process, 35 studies were included in the review. Almost three-quarters of the studies were published in the last 4 years. The studies reviewed concluded that EMA was generally feasible and well accepted. EMA findings correlated well with the results of a retrospective assessment, though tended to over-represent symptom severity. Our review points to important aspects of suicidal thoughts and behavior, such as its wide fluctuation over short periods of time. Negative affect and disturbed sleep, among others, emerged as short-term predictors of suicidal thoughts and behavior. Therefore, EMA is a potentially useful tool in clinical practice, although not without drawbacks, such as participant fatigue with questionnaires and ethical concerns.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Acknowledgements

The editors would like to thank Dr. Mark Larsen for taking the time to review this manuscript. The authors would like to thank Oliver Shaw, who helped in editing this article.

Availability of Data and Material

Under request.

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Not applicable.

Funding

This study received grant support from Instituto de Salud Carlos III (ISCIII PI13/02200; PI16/01852; CM19/00026), the American Foundation for Suicide Prevention (LSRG-1-005-16), the Spanish Ministry of Science, Innovation, and Universities (RTI2018-099655-B-I00; TEC2017-92552-EXP), the regional government of Madrid (Y2018/TCS-4705, PRACTICO-CM, PEJD-2018-PRE/SAL-8417), and the program providing financial support for the hiring of predoctoral and postdoctoral researchers, co-funded by the European Social Fund through the Operational Program on Youth Employment and the Youth Employment Initiative (YEI) (PEJD-2018-PRE/SAL-8417).

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Author notes

  1. Alba Sedano-Capdevilla and Alejandro Porras-Segovia as equal junior authors and Enrique Baca-García and Maria Luisa Barrigon as equal senior authors.

Authors and Affiliations

  1. Department of Psychiatry, Hospital Rey Juan Carlos, Móstoles, Spain

    Alba Sedano-Capdevila & Enrique Baca-García

  2. Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain

    Alejandro Porras-Segovia, Enrique Baca-García & Maria Luisa Barrigon

  3. Department of Applied Mathematics, Universidad de Valladolid, Soria Campus, Soria, Spain

    Hugo J. Bello

  4. CIBERSAM, Madrid, Spain

    Enrique Baca-García

  5. Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain

    Enrique Baca-García & Maria Luisa Barrigon

  6. Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

    Enrique Baca-García & Maria Luisa Barrigon

  7. Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain

    Enrique Baca-García

  8. Department of Psychiatry, Hospital Universitario General de Villalba, Madrid, Spain

    Enrique Baca-García

  9. Universidad Católica del Maule, Talca, Chile

    Enrique Baca-García

  10. Nimes University Hospital, Nimes, France

    Enrique Baca-García

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  1. Alba Sedano-Capdevila
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  4. Enrique Baca-García
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Correspondence to Maria Luisa Barrigon.

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Alba Sedano-Capdevila, Alejandro Porras-Segovia, Hugo J. Bello, and María Luisa Barrigón each declare no potential conflicts of interest.

Enrique Baca-García designed the MEmind application, an Ecological Momentary Assessment tool.

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Sedano-Capdevila, A., Porras-Segovia, A., Bello, H.J. et al. Use of Ecological Momentary Assessment to Study Suicidal Thoughts and Behavior: a Systematic Review. Curr Psychiatry Rep 23, 41 (2021). https://doi.org/10.1007/s11920-021-01255-7

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