Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, D.C., USA.
Brain Behav. 2023 Sep;13(9):e3134. doi: 10.1002/brb3.3134. Epub 2023 Aug 13.
Here, we examine whether the dynamics of the four dimensions of the circumplex model of affect assessed by ecological momentary assessment (EMA) differ among those with bipolar disorder (BD) and major depressive disorder (MDD).
Participants aged 11-85 years (n = 362) reported momentary sad, anxious, active, and energetic dimensional states four times per day for 2 weeks. Individuals with lifetime mood disorder subtypes of bipolar-I, bipolar-II, and MDD derived from a semistructured clinical interview were compared to each other and to controls without a lifetime history of psychiatric disorders. Random effects from individual means, inertias, innovation (residual) variances, and cross-lags across the four affective dimensions simultaneously were derived from multivariate dynamic structural equation models.
All mood disorder subtypes were associated with higher levels of sad and anxious mood and lower energy than controls. Those with bipolar-I had lower average activation, and lower energy that was independent of activation, compared to MDD or controls. However, increases in activation were more likely to perpetuate in those with bipolar-I. Bipolar-II was characterized by higher lability of sad and anxious mood compared to bipolar-I and controls but not MDD. Compared to BD and controls, those with MDD exhibited cross-augmentation of sadness and anxiety, and sadness blunted energy.
Bipolar-I is more strongly characterized by activation and energy than sad and anxious mood. This distinction has potential implications for both specificity of intervention targets and differential pathways underlying these dynamic affective systems. Confirmation of the longer term stability and generalizability of these findings in future studies is necessary.
在这里，我们研究通过生态瞬时评估（EMA）评估的情感双相模型的四个维度的动态是否在双相情感障碍（BD）和重度抑郁症（MDD）患者中有所不同。
年龄在 11-85 岁之间的参与者（n=362）在两周内每天四次报告即时的悲伤、焦虑、活跃和精力充沛的维度状态。从半结构化临床访谈中得出的具有双相情感障碍-I、双相情感障碍-II 和 MDD 终身心境障碍亚型的个体与彼此以及没有精神疾病终身病史的对照组进行了比较。从多变量动态结构方程模型中同时推导出个体均值、惯性、创新（残差）方差和四个情感维度之间的交叉滞后的随机效应。
所有心境障碍亚型的悲伤和焦虑情绪水平均高于对照组，且精力水平低于对照组。与 MDD 或对照组相比，I 型双相患者的平均激活水平较低，且其能量水平独立于激活水平较低。然而，I 型双相患者的激活增加更有可能持续存在。与 I 型双相相比，II 型双相的悲伤和焦虑情绪波动更大，但与 MDD 相比则不然。与 BD 和对照组相比，MDD 患者表现出悲伤和焦虑的交叉增强，以及悲伤削弱了能量。
I 型双相更强烈地表现为激活和能量，而不是悲伤和焦虑情绪。这一区别对于干预目标的特异性和这些动态情感系统的潜在途径都有潜在的影响。未来研究中需要确认这些发现的长期稳定性和普遍性。
