scholarly journals Patients at high risk of suicide before and during a COVID-19 lockdown: ecological momentary assessment study

BJPsych Open ◽  
2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Aurora Cobo ◽  
Alejandro Porras-Segovia ◽  
María Mercedes Pérez-Rodríguez ◽  
Antonio Artés-Rodríguez ◽  
Maria Luisa Barrigón ◽  
...  

The coronavirus disease 2019 (COVID-19) outbreak may have affected the mental health of patients at high risk of suicide. In this study we explored the wish to die and other suicide risk factors using smartphone-based ecological momentary assessment (EMA) in patients with a history of suicidal thoughts and behaviour. Contrary to our expectations we found a decrease in the wish to die during lockdown. This is consistent with previous studies showing that suicide rates decrease during periods of social emergency. Smartphone-based EMA can allow us to remotely assess patients and overcome the physical barriers imposed by lockdown.

2020 ◽  
Author(s):  
MORGIEVE Margot ◽  
catherine Genty ◽  
Jonathan Dubois ◽  
Marion Leboyer ◽  
Guillaume Vaiva ◽  
...  

Background: Many suicide risk factors have been identified, but traditional clinical methods do not allow the accurate prediction of suicide behaviors. To face this challenge, we developed emma, an app for Ecological Momentary Assessment/Intervention (EMA/EMI) and prediction of suicide risk in high risk patients.Objective: We wanted to test the feasibility of implementing this mHealth-based suicide risk assessment and prevention tool and its impact in subjects at high risk of suicide in real world conditions.Methods: The EMMA Study is an ongoing longitudinal interventional multicenter trial in which patients at high-risk for suicide (n=100) use emma for 6 months. During this period, they complete four EMA types (daily, weekly, monthly, spontaneous) and may use EMI modules. Participants undergo clinical assessment at month 0, 1, 3 and 6 after inclusion.Results: Among the 43 patients already recruited in the EMMA Study, 14 participants had completed the follow-up. Their data were analyzed to evaluate emma implementation and impact on suicide risk management. EMA completion rates were extremely heterogeneous among the 14 participants with a sharp decrease over time. The completion rates of the weekly EMA (25% to 87.5%) were higher than for the daily EMA (0% to 53.3%). Most patients (n=10/14) answered the EMA questionnaires spontaneously. Similarly, the Safety Plan Modules use was very heterogeneous (2 to 75 times). Specifically, 11 patients used the Call Module (1 to 29 times), designed by our team to help them to get in touch with healthcare professionals and/or relatives during a crisis. All patients used the Breathing Space Module and 8 the Emotion Regulation Module (1 to 46 times). The diversity of patient profiles and use of the EMA and EMI modules proposed by emma was highlighted by three case reports.Conclusions: These preliminary results suggest that it is possible and acceptable to collect longitudinal fine-grained contextualized data (EMA) and to offer personalized intervention (EMI) in real time to people at high risk of suicide. Patients have different clinical and digital profiles and needs that require a highly scalable, interactive and customizable app. To become a complementary tool for suicide prevention, emma should be integrated in the existing emergency procedures.


2019 ◽  
Author(s):  
Margot Morgiève ◽  
Catherine Genty ◽  
Jérôme Azé ◽  
Jonathan Dubois ◽  
Marion Leboyer ◽  
...  

BACKGROUND Many suicide risk factors have been identified, but traditional clinical methods do not allow for the accurate prediction of suicide behaviors. To face this challenge, <i>emma</i>, an app for ecological momentary assessment (EMA), ecological momentary intervention (EMI), and prediction of suicide risk in high-risk patients, was developed. OBJECTIVE The aim of this case report study was to describe how subjects at high risk of suicide use the <i>emma</i> app in real-world conditions. METHODS The Ecological Mental Momentary Assessment (EMMA) study is an ongoing, longitudinal, interventional, multicenter trial in which patients at high risk for suicide are recruited to test <i>emma</i>, an app designed to be used as a self-help tool for suicidal crisis management. Participants undergo clinical assessment at months 0, 1, 3, and 6 after inclusion, mainly to assess and characterize the presence of mental disorders and suicidal thoughts and behaviors. Patient recruitment is still ongoing. Some data from the first 14 participants who already completed the 6-month follow-up were selected for this case report study, which evaluated the following: (1) data collected by <i>emma</i> (ie, responses to EMAs), (2) metadata on <i>emma</i> use, (3) clinical data, and (4) qualitative assessment of the participants' experiences. RESULTS EMA completion rates were extremely heterogeneous with a sharp decrease over time. The completion rates of the weekly EMAs (25%-87%) were higher than those of the daily EMAs (0%-53%). Most patients (10/14, 71%) answered the EMA questionnaires spontaneously. Similarly, the use of the Safety Plan Modules was very heterogeneous (2-75 times). Specifically, 11 patients out of 14 (79%) used the Call Module (1-29 times), which was designed by our team to help them get in touch with health care professionals and/or relatives during a crisis. The diversity of patient profiles and use of the EMA and EMI modules proposed by <i>emma</i> were highlighted by three case reports. CONCLUSIONS These preliminary results indicate that patients have different clinical and digital profiles and needs that require a highly scalable, interactive, and customizable app. They also suggest that it is possible and acceptable to collect longitudinal, fine-grained, contextualized data (ie, EMA) and to offer personalized intervention (ie, EMI) in real time to people at high risk of suicide. To become a complementary tool for suicide prevention, <i>emma</i> should be integrated into existing emergency procedures. CLINICALTRIAL ClinicalTrials.gov NCT03410381; https://clinicaltrials.gov/ct2/show/NCT03410381


10.2196/15741 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e15741 ◽  
Author(s):  
Margot Morgiève ◽  
Catherine Genty ◽  
Jérôme Azé ◽  
Jonathan Dubois ◽  
Marion Leboyer ◽  
...  

Background Many suicide risk factors have been identified, but traditional clinical methods do not allow for the accurate prediction of suicide behaviors. To face this challenge, emma, an app for ecological momentary assessment (EMA), ecological momentary intervention (EMI), and prediction of suicide risk in high-risk patients, was developed. Objective The aim of this case report study was to describe how subjects at high risk of suicide use the emma app in real-world conditions. Methods The Ecological Mental Momentary Assessment (EMMA) study is an ongoing, longitudinal, interventional, multicenter trial in which patients at high risk for suicide are recruited to test emma, an app designed to be used as a self-help tool for suicidal crisis management. Participants undergo clinical assessment at months 0, 1, 3, and 6 after inclusion, mainly to assess and characterize the presence of mental disorders and suicidal thoughts and behaviors. Patient recruitment is still ongoing. Some data from the first 14 participants who already completed the 6-month follow-up were selected for this case report study, which evaluated the following: (1) data collected by emma (ie, responses to EMAs), (2) metadata on emma use, (3) clinical data, and (4) qualitative assessment of the participants' experiences. Results EMA completion rates were extremely heterogeneous with a sharp decrease over time. The completion rates of the weekly EMAs (25%-87%) were higher than those of the daily EMAs (0%-53%). Most patients (10/14, 71%) answered the EMA questionnaires spontaneously. Similarly, the use of the Safety Plan Modules was very heterogeneous (2-75 times). Specifically, 11 patients out of 14 (79%) used the Call Module (1-29 times), which was designed by our team to help them get in touch with health care professionals and/or relatives during a crisis. The diversity of patient profiles and use of the EMA and EMI modules proposed by emma were highlighted by three case reports. Conclusions These preliminary results indicate that patients have different clinical and digital profiles and needs that require a highly scalable, interactive, and customizable app. They also suggest that it is possible and acceptable to collect longitudinal, fine-grained, contextualized data (ie, EMA) and to offer personalized intervention (ie, EMI) in real time to people at high risk of suicide. To become a complementary tool for suicide prevention, emma should be integrated into existing emergency procedures. Trial Registration ClinicalTrials.gov NCT03410381; https://clinicaltrials.gov/ct2/show/NCT03410381


2021 ◽  
Vol 22 (5) ◽  
pp. 612
Author(s):  
Matthew Herbert ◽  
Jennalee Wooldridge ◽  
Emily Paolillo ◽  
Colin Depp ◽  
Raeanne Moore

2021 ◽  
Vol 140 ◽  
pp. 103832
Author(s):  
Kristján Helgi Hjartarson ◽  
Ivar Snorrason ◽  
Laura F. Bringmann ◽  
Bjarni E. Ögmundsson ◽  
Ragnar P. Ólafsson

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