Conclusions  Electronic self-monitoring of mood in depression appears to be a valid measure of mood in contrast to self-monitoring of mood in mania .
Background Various paper-based mood charting instruments are used in the monitoring of symptoms in bipolar disorder .
During recent years an increasing number of electronic self-monitoring tools have been developed .
The objectives of this systematic review were 1 ) to evaluate the validity of electronic self-monitoring tools as a method of evaluating mood compared to clinical rating scales for depression and mania and 2 ) to investigate the effect of electronic self-monitoring tools on clinical ly relevant outcomes in bipolar disorder .
There are yet few studies on the effect of  electronic self-monitoring of mood  in bipolar disorder .
The Ins and Outs of an Online Bipolar Education Program: A Study of Program Attrition
Background The science of eHealth interventions is rapidly evolving . However , despite positive outcomes , evaluations of eHealth applications have thus far failed to explain the high attrition rates that are associated with some eHealth programs . Patient adherence remains an issue , and the science of attrition is still in its infancy . To our knowledge , there has been no in-depth qualitative study aim ed at identifying the reasons for nonadherence to— and attrition from— online interventions . Objective This paper explores the predictors of attrition and participant-reported reasons for nonadherence to an online psycho-education program for people newly diagnosed with a bipolar disorder . Methods As part of an ongoing r and omized controlled trial ( RCT ) evaluating an online psycho-education program for people newly diagnosed with a bipolar disorder , we undertook an in-depth qualitative study to identify participants ’ reasons for nonadherence to , and attrition from , the online intervention as well as a quantitative study investigating predictors of attrition . Within the RCT , 370 participants were r and omly allocated to 1 of 2 active interventions or an attention control condition . Descriptive analyses and chi-square tests were used to explore the completion rates of 358 participants , and st and ard regression analysis was used to identify predictors of attrition . The data from interviews with a sub sample of 39 participants who did not complete the online program  were analyzed using “ thematic analysis ” to identify patterns in reported reasons for attrition . Results Overall , 26.5 % of the sample did not complete their assigned intervention . St and ard multiple regression analysis revealed that young age ( P= .004 ) , male gender ( P= .001 ) , and clinical recruitment setting ( P= .001 ) were significant predictors of attrition ( F7,330= 8.08 , P < .001 ) . Thematic analysis of interview data from the noncompleter sub sample revealed that difficulties associated with the acute phases of bipolar disorder , not wanting to think about one ’s illness , and program factors such as the information being too general and not personally tailored were the major reasons for nonadherence . Conclusions The dropout rate was equivalent to other Internet interventions and to face-to-face therapy . Findings from our qualitative study provide participant-reported reasons for discontinuing the online intervention , which , in conjunction with the quantitative investigations about predictors , add to underst and ing about Internet interventions . However , further research is needed to determine whether there are systematic differences between those who complete and those who do not complete eHealth interventions . Ultimately , this may lead to the identification of population subgroups that most benefit from eHealth interventions and to informing the development of strategies to improve adherence . Trial Registration ACTRN12608000411347 ; http://www.anzctr.org.au/ACTRN12608000411347.aspx ( Archived by WebCite at http://www.webcitation.org/5uX4uYwVN
Conclusions  Electronic self-monitoring of mood in depression appears to be a valid measure of mood in contrast to self-monitoring of mood in mania .
Background Various paper-based mood charting instruments are used in the monitoring of symptoms in bipolar disorder .
During recent years an increasing number of electronic self-monitoring tools have been developed .
The objectives of this systematic review were 1 ) to evaluate the validity of electronic self-monitoring tools as a method of evaluating mood compared to clinical rating scales for depression and mania and 2 ) to investigate the effect of electronic self-monitoring tools on clinical ly relevant outcomes in bipolar disorder .
There are yet few studies on the effect of  electronic self-monitoring of mood  in bipolar disorder .