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Objective: The current qualitative study aimed to map the relevance of the experience sampling method (ESM) for psychiatric practice and identify barriers and facilitators for implementation, as perceived by patients and clinicians. Methods: Participants were 22 patients with various diagnoses and 21 clinicians (e.g., psychiatrists, psychologists) who participated in interviews or focus groups. Using Atlas.TI, qualitative thematic analysis was conducted to analyze the transcripts, resulting in four themes: 1) applications, 2) advantages, 3) undesirable effects, and 4) requirements for implementation of ESM in care. Results: Clinicians and patients believed ESM could be relevant in every phase of care to increase patients' awareness, insight and self-management, personalize interventions, and alert patients to rising symptoms. Further, ESM was expected to improve the patient-clinician relationship, lead to objective, personalized, reliable and visual data, and increase efficiency of care. However, participants warned against high assessment burden and potential symptom worsening. Conclusions: This study provides first evidence that the potential of ESM is recognized by both patients and clinicians. Key recommendations for optimal implementation of ESM in psychiatric care include flexible application of ESM, collaboration between patient and clinician, regular evaluation, awareness of negative reactivity, availability to patients with different psychiatric syndromes, and implementation by an interdisciplinary team of patients, clinicians, researchers, and information technology specialists.

PurposeRecent reviews have questioned the efficacy of selective serotonin reuptake inhibitors (SSRIs) above placebo response, and their working mechanisms remain unclear. New approaches to understanding the effects of SSRIs are necessary to enhance their efficacy. The aim of this study was to explore the possibilities of using cross-sectional network analysis to increase our understanding of symptom connectivity before and after SSRI treatment.MethodsIn two randomized controlled trials (total N = 178), we estimated Gaussian graphical models among 20 symptoms of the Beck Depression Inventory-II before and after 8 weeks of treatment with the SSRI paroxetine. Networks were compared on connectivity, community structure, predictability (proportion explained variance), and strength centrality (i.e., connectedness to other symptoms in the network).ResultsSymptom severity for all individual BDI-II symptoms significantly decreased over 8 weeks of SSRI treatment, whereas interconnectivity and predictability of the symptoms significantly increased. At baseline, three communities were detected; five communities were detected at week 8.ConclusionsFindings suggest the effects of SSRIs can be studied using the network approach. The increased connectivity, predictability, and communities at week 8 may be explained by the decrease in depressive symptoms rather than specific effects of SSRIs. Future studies with larger samples and placebo controls are needed to offer insight into the effects of SSRIs.Trial RegistrationThe trials described in this manuscript were funded by the NIMH.Pennsylvania/Vanderbilt study:5 R10 MH55877 (https://projectreporter.nih.gov/project_info_description.cfm?aid=6186633&icde=28344168&ddparam=&ddvalue=&ddsub=&cr=1&csb=default&cs=ASC&MMOpt=).Washington study:R01 MH55502 (https://projectreporter.nih.gov/project_info_description.cfm?aid=2034618&icde=28344217&ddparam=&ddvalue=&ddsub=&cr=5&csb=default&cs=ASC).Electronic supplementary materialThe online version of this article (10.1007/s00127-018-1506-1) contains supplementary material, which is available to authorized users.