@Article{info:doi/10.2196/11711,
author="Mets{\"a}ranta, Kiki
and Kurki, Marjo
and Valimaki, Maritta
and Anttila, Minna",
title="How Do Adolescents Use Electronic Diaries? A Mixed-Methods Study Among Adolescents With Depressive Symptoms",
journal="J Med Internet Res",
year="2019",
month="Feb",
day="20",
volume="21",
number="2",
pages="e11711",
keywords="adolescent; depression; electronic diary; mental health; mobile phone; outpatient care",
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. ",
issn="1438-8871",
doi="10.2196/11711",
url="http://www.jmir.org/2019/2/e11711/",
url="https://doi.org/10.2196/11711",
url="http://www.ncbi.nlm.nih.gov/pubmed/30785408"
}