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Ecological Momentary Interventions for Bipolar Disorder: A Systematic Review and Meta-Analysis Publisher



Hirbodmobarakeh A1, 2 ; Keshavarzakhlaghi AA3 ; Hadi F2 ; Eghdami S2, 4, 7 ; Hirbodmobarakeh A1, 2 ; Kalhori SH1 ; Khanipourkencha A5, 6
Authors
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Authors Affiliations
  1. 1. Hirbod Psychiatric and Psychologic Club (BAVAR), Tehran, Iran
  2. 2. Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  3. 3. Mental Health Research Center, Department of Psychiatry, School of Medicine, Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran
  4. 4. Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Hemat Highway, Next to Milad Tower, Tehran, 14535, Iran

Source: Social Psychiatry and Psychiatric Epidemiology Published:2025


Abstract

Background and objectives: Bipolar Disorders affect 2% of the world population and ranks as the sixth leading cause of disability. Barriers such as lack of insight and limited access to healthcare result in a significant disease burden. These barriers can be mitigated by technology-delivered interventions such as ecological momentary interventions, which provide personalized, real-time treatments based on ecological momentary assessments of relevant variables. This review aimed to assess the effectiveness of ecological momentary interventions in bipolar disorder. Methods: We conducted searches across Medline, Scopus, CENTRAL, psychINFO and ProQuest without applying any filter through December 30, 2023. Two authors screened results to eliminate irrelevant and duplicate studies, and the remaining studies were independently reviewed. Data were extracted, transformed into a common rubric, and analyzed for treatment effects using Review Manager 5. Findings: We analyzed 14 studies, encompassing 1776 patients with bipolar disorder. Interventions were mostly based on psychoeducation and cognitive behavioral therapy. EMI had small to moderate effects on quality of life (SMD = 0.24; 95% CI = 0.04–0.44, P = 0.02; I² = 47%), medication adherence (SMD = 0.21; 95% CI = 0.03–0.39, P = 0.02; I² = 0%), and affective episodes (HR = 0.75; 95% CI = 0.57–0.98, P = 0.04; I² = 0%). Conclusion: Ecological momentary intervention is a novel area of research in behavioral science. The results of this systematic review based on the available literature suggest that these interventions could be beneficial for patients with bipolar disorder. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2025.
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