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Title: How do adolescents use electronic diaries? A mixed-methods study among adolescents with depressive symptoms
Authors: Metsaranta, K
Kurki, M
Valimaki, M 
Anttila, M
Issue Date: 2019
Source: Journal of medical Internet research, 20 Feb. 2019, v. 21, no. 2, e11711, p. 1-10
Abstract: Background: Depression in adolescence is common. Less than half of the adolescents with depression receive mental health care; furthermore, treatment tends to be suspended, and its success rates are low. There is a need for these adolescents to have a safe place to share their thoughts. Studies have shown that writing may be a useful treatment method for people with mental health problems.
Objective: This study aims to describe the use of an electronic diary (e-diary) among adolescents with depressive symptoms.
Methods: This paper describes a substudy of a randomized controlled trial. We used a mixed-methods approach to understand the way in which e-diaries were used by participants in the intervention under the randomized controlled trial. Data were collected during 2008-2010 at 2 university hospitals in Finland. Study participants (N=89) were 15-17-year-old adolescents who had been referred to an adolescent outpatient psychiatric clinic due to depressive symptoms. Participants were instructed to use the e-diary at least once a week to describe their thoughts, feelings, and moods. The content of the e-diary data was analyzed using descriptive statistics and inductive content analysis.
Results: Overall, 53% (47/89) of the adolescents used the e-diary. Most of them (39/47, 83%) logged into the program during the first week, and about one-third (19/47, 40%) logged into the e-diary weekly as suggested. The number of words used in the e-diary per each log ranged between 8 and 1442 words. The 3 topics most often written about in the e-diary were related to mental health problems (mental disorder), social interaction (relationship), and one's own development (identity). Conclusions: An e-diary may be a usable tool to reflect experiences and thoughts, especially among adolescents who have signs of depression. The results of this study can be used to develop user-centered electronic health applications that allow users to express their own thoughts and experiences in ways other than systematic mood monitoring.
Keywords: Adolescent
Depression
Electronic diary
Mental health
Mobile phone
Outpatient care
Publisher: JMIR Publications, Inc.
Journal: Journal of medical Internet research 
ISSN: 1439-4456
EISSN: 1438-8871
DOI: 10.2196/11711
Rights: ©Kiki Metsäranta, Marjo Kurki, Maritta Valimaki, Minna Anttila. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.02.2019.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
The following publication Metsäranta K, Kurki M, Valimaki M, Anttila M. How Do Adolescents Use Electronic Diaries? A Mixed-Methods Study Among Adolescents With Depressive Symptoms. J Med Internet Res 2019;21(2):e11711, 10 pages is available at https://dx.doi.org/10.2196/11711
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