Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China.
Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China.
Eur Psychiatry. 2023 Aug 7;66(1):e67. doi: 10.1192/j.eurpsy.2023.2438.
Affective disturbances in schizophrenia and bipolar disorder may represent a transdiagnostic etiological process as well as a target of intervention. Hypotheses on similarities and differences in various parameters of affective dynamics (intensity, successive/acute changes, variability, and reactivity to stress) between the two disorders were tested.
Experience sampling method was used to assess dynamics of positive and negative affect, 10 times a day over 6 consecutive days. Patients with schizophrenia ( = 46) and patients with bipolar disorder ( = 46) were compared against age-matched healthy controls ( = 46).
Compared to controls, the schizophrenia group had significantly more intense momentary negative affect, a lower likelihood of acute changes in positive affect, and reduced within-person variability of positive affect. The bipolar disorder group was not significantly different from either the schizophrenia group or the healthy control group on any affect indexes. Within the schizophrenia group, level of depression was associated with weaker reactivity to stress for negative affect. Within the bipolar disorder group, level of depression was associated with lower positive affect.
Patients with schizophrenia endured a more stable and negative affective state than healthy individuals, and were less likely to be uplifted in response to happenings in daily life. There is little evidence that these affective constructs characterize the psychopathology of bipolar disorder; such investigation may have been limited by the heterogeneity within group. Our findings supported the clinical importance of assessing multiple facets of affective dynamics beyond the mean levels of intensity.
精神分裂症和双相情感障碍中的情感障碍可能代表一种跨诊断的发病机制，也是干预的目标。本研究旨在检验两种疾病在情感动力学的各种参数（强度、连续/急性变化、变异性和对压力的反应性）方面存在相似和不同之处的假设。
使用经验采样法，在连续 6 天内每天评估 10 次积极和消极情绪的动态变化。将精神分裂症患者（n=46）和双相情感障碍患者（n=46）与年龄匹配的健康对照组（n=46）进行比较。
与对照组相比，精神分裂症组的瞬间负性情绪强度显著更高，正性情绪急性变化的可能性更低，正性情绪的个体内变异性降低。在任何情感指标上，双相情感障碍组与精神分裂症组或健康对照组均无显著差异。在精神分裂症组中，抑郁水平与负性情绪对压力的反应性减弱有关。在双相情感障碍组中，抑郁水平与正性情绪较低有关。
与健康个体相比，精神分裂症患者的情绪状态更稳定且更消极，对日常生活中的事件反应不太可能得到提升。几乎没有证据表明这些情感结构是双相情感障碍的精神病理学特征；这种研究可能受到组内异质性的限制。我们的研究结果支持了评估情感动力学的多个方面而不仅仅是强度平均值的临床重要性。
