Faculty of Health and Medical Sciences, The Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, 6243, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Faculty of Health and Medical Sciences, The Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, 6243, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
J Affect Disord. 2020 Jun 15;271:336-344. doi: 10.1016/j.jad.2020.03.049. Epub 2020 Mar 27.
To investigate whether mood instability (MI) qualify as a trait marker for bipolar disorder (BD) we investigated: 1) differences in smartphone-based self-reported MI between three groups: patients with newly diagnosed BD, unaffected first-degree relatives (UR), and healthy control individuals (HC); 2) the correlation between MI and functioning, stress, and duration of illness, respectively; and 3) the validity of smartphone-based self-evaluated mood ratings as compared to observer-based ratings of depressed and manic mood.
203 patients with newly diagnosed BD, 54 UR and 109 HC were included as part of the longitudinal Bipolar Illness Onset study. Participants completed daily smartphone-based mood ratings for a period of up to two years and were clinically assessed with ratings of depression, mania and functioning.
Mood instability scores were statistically significantly higher in patients with BD compared with HC (mean=1.18, 95%CI: 1.12;1.24 vs 1.05, 95%CI: 0.98;1.13, p = 0.007) and did not differ between patients with BD and UR (mean=1.17, 95%CI: 1.07;1.28, p = 0.91). For patients, increased MI scores correlated positively with impaired functioning (p<0.001), increased stress level (p<0.001) and increasing number of prior mood episodes (p<0.001). Smartphone-based mood ratings correlated with ratings of mood according to sub-item 1 on the Hamilton Depression Rating Scale 17-items and the Young Mania Rating Scale, respectively (p´s<0.001).
The study had a smaller number of UR than planned.
Mood instability is increased in patients with newly diagnosed BD and unaffected relatives and associated with decreased functioning. The findings highlight MI as a potential trait marker for BD.
为了探究心境不稳（MI）是否可作为双相障碍（BD）的特质标志物，我们进行了以下研究：1）比较三组人群（新诊断 BD 患者、未受影响的一级亲属（UR）和健康对照个体（HC））基于智能手机的自我报告 MI 差异；2）分别比较 MI 与功能、应激和疾病持续时间的相关性；3）与基于观察者的抑郁和躁狂心境评估相比，基于智能手机的自我评估心境评分的有效性。
共纳入 203 例新诊断 BD 患者、54 例 UR 和 109 例 HC 作为纵向双相障碍发作研究的一部分。参与者完成了长达两年的基于智能手机的日常心境评分，同时接受了抑郁、躁狂和功能的临床评估。
与 HC 相比，BD 患者的 MI 评分明显更高（平均值=1.18，95%CI：1.12；1.24 vs 1.05，95%CI：0.98；1.13，p=0.007），且与 BD 患者和 UR 之间的差异无统计学意义（平均值=1.17，95%CI：1.07；1.28，p=0.91）。对于患者而言，MI 评分的增加与功能受损（p<0.001）、应激水平增加（p<0.001）和既往心境发作次数增加（p<0.001）呈正相关。基于智能手机的心境评分与汉密尔顿抑郁量表 17 项和 Young 躁狂评定量表的子项 1 分别评估的心境评分相关（p 值均<0.001）。
UR 的数量比计划的少。
新诊断 BD 患者和未受影响的亲属的心境不稳增加，与功能下降相关。这些发现强调了 MI 作为 BD 潜在特质标志物的作用。
