Pending challenges to e-mental health in the COVID-19 era: Acceptability of a smartphone-based ecological momentary assessment application among patients with schizophrenia spectrum disorders

IntroductionConcerns have been raised about ecological momentary assessment (EMA) acceptability among patients with schizophrenia spectrum disorders (SSD), which is of major relevance during the e-Mental health-focused COVID-19 pandemic.ObjectivesTo investigate i) the levels of adherence to a passive smartphone-based EMA tool, the Evidence-Based Behavior (eB2), among SSD patients; and ii) putative predictors of this.MethodsSample: SSD (F20-29-ICD10) outpatients, age 18-64, without financial incentives, recruited over 17/06/2019-11/03/2020 at the Hospital Universitario Fundación Jiménez Díaz (Madrid, Spain). Those who accepted the eB2 installation -users- and those who did not -non-users- were compared in sociodemographic, clinical, premorbid adjustment, neurocognitive, psychopathological, insight and metacognitive variables by a multivariable binary logistic regression model.ResultsSample (N=77): n=41 males; age: 47.69±9.76 years, n=24 users (31.2%). n=14 users (70%) had the eB2 installed at follow-up (median=14.50 weeks).Multivariable binary logistic regression model on ‘user’ as outcomeβSEWaldpOR95% CIAge-0.0750.0383.9100.0480.9280.861-0.999Education level-0.9671.2890.5630.4530.3800.030-4.755Early adolescence premorbid adjustment-0.2850.1106.6950.0100.7520.606-0.933Trail Making Test A-0.0300.0251.4880.2220.9700.924-1.018Trail Making Test B-0.0050.0100.2780.5980.9950.976-1.014Cognitive Insight0.0620.0611.0430.3071.0640.944-1.200X2=25.296,df=6,p