The relationship between conventional clinical assessments and momentary assessments of symptoms and functioning in schizophrenia spectrum disorders: A systematic review.

Background: Symptoms and functioning are critical dimensions in those with schizophrenia and are typically measured using validated conventional clinical assessments. Researchers and clinicians have begun to use real-time digital methods, such as ecological momentary assessment (EMA), to assess symptoms and functioning in the moment and outside of traditional hospital and laboratory settings, which may yield more naturalistic data. Although digital methods have advantages, it is unclear whether these momentary assessments capture core aspects of symptoms and functioning.

Objective: This systematic literature review aimed to evaluate the association between conventional clinical and momentary-based assessments of functioning and symptoms in individuals with schizophrenia.

Methods: Studies were included if they met the following criteria: (1) written or translated into English; (2) peer-reviewed; (3) included primary quantitative data; (4) 60% of the clinical sample included persons with schizophrenia spectrum disorders; (5) included a clinical assessment of functioning and/or symptoms; (6) included active momentary assessment and/or passive data; and (7) assessed the relationship between the momentary and conventional clinical assessments.

Results: A total of 49 studies (87 analyses) were included. Conventional clinical assessments of functioning and positive, negative, and depressive symptoms were related to momentary assessments of these symptom domains. Passive data was beneficial for assessing negative symptoms, but research is warranted for other domains.

Conclusions: The reviewed studies highlight the utility of EMA methodologies to collect detailed data on symptoms and functioning. Such data is being used to develop more sophisticated models of schizophrenia to enhance our understanding of important mechanisms and develop targeted interventions.