The use of ecological momentary assessment methods and designs in the context of obsessive-compulsive disorder: A systematic review

Background: Ecological momentary assessment (EMA) is becoming an increasingly prevalent methodology in the field of obsessive-compulsive disorder (OCD) research, offering a means of capturing symptom fluctuations in real-time. Although its flexibility allows it to be adapted to a wide range of study objectives, there is currently no comprehensive study of EMA designs in OCD research. Methods: A systematic search identified 34 studies that employed EMA with patients diagnosed with OCD. Data were extracted on the study objectives, sampling schedules, data collection platforms, response scales, and variables assessed. Items content was subjected to qualitative analysis to categorize the theme assessed. Results: There was considerable variation in the studies' designs. The mean duration of data collection varied from one to seven days, with an average of four daily assessments. A total of 374 items were extracted, and 12 themes were identified. The most frequent item themes were related to OCD symptoms (49.7 %) and mood/ emotions (27 %). The platforms used included digital devices (35.3 %) and traditional pen-and-paper methods (58.8 %). Response rates, reported in only 32.4 % of studies, averaged 74.2 %, while dropout rates averaged 24.8 %. The variability of the methods underlined the adaptability of EMA, but also highlighted standardization challenges. Conclusions: Item themes related to OCD symptoms and mood were dominant, reflecting the focus of EMA on capturing dynamic processes. Summarising the methodological trends identified in this review provides a foundation for improving design and standardization in future EMA-based OCD research. Systematic review registration: [CRD42023406887].