Lay Summary

• We evaluated inter- and intra-individual differences in mood variability and instability between patients with SSD and healthy controls during the daily hours and the weekdays. • We found that residential patients reported the highest negative mood levels, and displayed the highest variability in positive mood across daily hours and weekdays. • Evaluating emotional experiences in the complex daily life of patients with SSD is fundamental to develop personalized treatment plans.

Background

Evaluating emotional experiences in the complex daily life of patients with Schizophrenia Spectrum Disorders (SSD) is fundamental to develop personalized treatment plans. However, little is known about mood variability and instability among patients with SSD and the general population. We evaluated inter- and intra-individual differences in mood variability between patients with SSD living in different treatment settings and healthy controls during the day and during the week

Methods

From October 2020 to October 2021, 102 patients diagnosed with SSD (56 residential patients, 46 outpatient) and 111 healthy controls were recruited at ten different centers in Northern Italy, as part of the DiAPAson project. Healthy controls were recruited by public advertisements and snowball sampling procedures, and were matched by gender and age group with the clinical sample. Mood was assessed with a brief questionnaire on a smartphone-based application for Experience Sampling Method (ESM), developed ad hoc for this project.

Results

We found that overall mean ratings of positive mood were not significantly different between patients and healthy controls, whereas patients with SSD reported higher levels of negative mood. There was a marked variability of mood ratings over different daily hours and weekdays. Both across daily hours and week days, residential patients showed the highest levels of negative mood compared to both outpatients and healthy controls. Negative mood slightly increased from morning hours to evening hours in all three groups. Additional analyses will investigate mood variability and instability in these three groups.

Conclusion

These findings contribute to a better understanding of the emotional experiences of patients with SSD in the complex world of the daily life. This knowledge is fundamental to develop personalized treatment plans