McKnight Rebecca F, Bilderbeck Amy C, Miklowitz David J, Hinds Christopher, Goodwin Guy M, Geddes John R
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
J Affect Disord. 2017 Dec 1;223:139-145. doi: 10.1016/j.jad.2017.07.029. Epub 2017 Jul 10.
Online self-monitoring of mood can be used to investigate differences in course patterns across patient groups. This study explored the feasibility of remote symptom capture with True Colours, a self-rated online mood monitoring tool completed on a weekly basis.
Participants with bipolar disorder (N = 297) completed weekly depression and mania questionnaires over an average of 27.5 months (range 1 -81 months). Subgroups defined by sex, age, and bipolar I vs. II status were compared on time in various mood states, number of episodes, and week-to-week mood variability.
Compliance with weekly questionnaires was generally high (median, 92% of weeks). Mood symptoms occurred for an average of 55.4% of weeks across the follow-up period. Females spent more time with hypomanic/manic and depressive symptoms and had more depressive episodes compared to males. Younger participants were found to experience more hypomanic/manic episodes and showed greater variability in mood symptoms than older participants. No significant differences in mood symptoms or variability were observed between bipolar I and II patients.
This was a naturalistic study with a heterogeneous cohort, and did not include a control group. True Colours does not identify mood fluctuations that may occur in the days between weekly assessments.
Monitoring moods through an online tool is both feasible and informative regarding course of illness in patients with bipolar disorder. Interventions aiming to reduce mood variability and manic/hypomanic episodes in the early phases of bipolar disorder may enhance the long-term symptomatic course of the illness.
情绪的在线自我监测可用于研究不同患者群体病程模式的差异。本研究探讨了使用“真色彩”（True Colours）进行远程症状捕捉的可行性，“真色彩”是一种每周完成一次的自评在线情绪监测工具。
双相情感障碍患者（N = 297）平均在27.5个月（范围1 - 81个月）内每周完成抑郁和躁狂问卷。比较了按性别、年龄以及双相I型与II型状态定义的亚组在不同情绪状态下的时间、发作次数和每周情绪变异性。
对每周问卷的依从性总体较高（中位数为92%的周数）。在随访期间，情绪症状平均出现于55.4%的周数。与男性相比，女性处于轻躁狂/躁狂和抑郁症状状态的时间更长，且抑郁发作更多。发现较年轻的参与者经历更多的轻躁狂/躁狂发作，并且与年长参与者相比，情绪症状的变异性更大。双相I型和II型患者在情绪症状或变异性方面未观察到显著差异。
这是一项针对异质性队列的自然主义研究，且未包括对照组。“真色彩”无法识别每周评估之间几天可能出现的情绪波动。
通过在线工具监测情绪对于双相情感障碍患者的病程而言既可行又能提供信息。旨在减少双相情感障碍早期情绪变异性和躁狂/轻躁狂发作的干预措施可能会改善该疾病的长期症状病程。
