In summary

Symptom tracking in psychiatry supports patient engagement and self-management, while also providing healthcare professionals (HCPs) with valuable information about a patient’s disease course
Traditional symptom-tracking tools will likely continue to be valuable in the future in situations when they are best suited to patient needs and preferences
Looking ahead to the future of psychiatric care, traditional symptom-tracking methods and digital mental health tools may be seen as contributing to the psychiatrist’s toolkit to provide a more holistic and personalized form of care

Symptom tracking in psychiatry supports patient engagement and self-management, while also helping HCPs to monitor patient status, identify triggers, and plan interventions – all of which are intended to improve patient prognosis.¹ Additionally, clinically relevant events, thoughts, behaviors, emotions, and psychological reactions that may not be accessible to external observation nor occur in therapy sessions can be monitored in the patient’s day-to-day life.¹ Real-time recording of symptoms allows both patients and HCPs to develop a more accurate picture of long-term states of mind.¹

Simple in format, effective in delivery: Traditional symptom-tracking methods at a glance

It is valuable to remind ourselves that these traditional methods of symptom tracking are relatively inexpensive and require very few HCP resources.¹ For example, in patients with bipolar disorder, forms of paper-based tracking include journals, sticky notes, charts, and calendars.² Additionally, providing patients with psychiatric disorders with the responsibility of tracking their own mood enables them to become active participants in shared decision-making with their HCPs.³ Increased variability in mood ratings can predict future depressive episodes, which may facilitate timely interventions and improve patient prognosis.⁴ The Social Rhythm Metric (SRM-5) is a tool that patients with bipolar disorder use to record their energy ratings at five key time points during the day.⁵ Disrupted circadian rhythms can lead to mood episodes in vulnerable individuals; however, by setting specific goals to stabilize daily rhythms in collaboration with the HCP, patients can stabilize their daily rhythms, which has been associated with symptomatic improvement.⁵

Combined use of digital mental health tools and traditional methods may significantly improve patient care

Some may argue that the advent of digital therapeutics will replace the more traditional therapy tools;⁶ however, the sustained use of these traditional symptom-tracking methods may be beneficial for two key reasons. Firstly, experience with their use can inform and potentially expedite digital mental health tool development.⁵ Secondly, traditional tools may be a useful complement to digital tools. Consider, as an example, the use of ecological momentary assessment (EMA) as a means of collating clinical and functional data through repeated “in the moment” sampling.⁷ The use of EMA is a demonstration that integration of traditional symptom-tracking and digital health tools can support symptom assessments in patients with schizophrenia or bipolar disorder.⁷ Furthermore, EMA may be a valuable adjunct for treatment studies, including psychosocial and pharmacological approaches. Tracking tools such as EMA highlight the potential of traditional tools as being a useful complement to digital tools, by providing a fuller toolkit for more holistic and personalized care,⁵ with the ultimate goal of allowing people with mental health conditions to thrive.

References:

Proudfoot J & Nicholas J. Monitoring and evaluation in low intensity CBT interventions. In Oxford guide to low intensity CBT interventions, 1st ed., 2010; pp. 97–104.
Murnane EL, et al. J Am Med Inform Assoc 2016;23:477–484.
Hong RH, et al. Neuropsychiatr Dis Treat 2021;17:79–90.
Nahum M, et al. JMIR Mhealth Uhealth 2017;5:e44.
Matthews M, et al. Assessment 2016;23:472–483.
Dang A, et al. J Family Med Prim Care 2020;9:2207–2213.
Harvey PD, et al. Innov Clin Neurosci 2021;18:24–30.