Bayas Maximilian, Kockler Tobias D, Ramos-Quiroga Josep Antoni, Caller Silvia Muñoz, Fadeuilhe Christian, de Girolamo Giovanni, Iozzino Laura, D'Addazio Miriam, Haavik Jan, Halmøy Anne, Hellum Karin Schiøler, Kolle Joakim Njaastad, Osnes Berge, Lundervold Astri J, Perroud Nader, Hasler Roland, De Almeida Mélanie Teixeira, Ebner-Priemer Ulrich W, Thanarajah Sharmili Edwin, Schiweck Carmen, Matura Silke, Repple Jonathan, Reif Andreas, Aichholzer Mareike
Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt-Goethe University, Frankfurt am Main, Germany.
Mental mHealth Lab, Karlsruhe Institute of Technology, Karlsruhe, Germany.
Int J Bipolar Disord. 2024 Dec 28;12(1):44. doi: 10.1186/s40345-024-00367-2.
Attention-deficit/hyperactivity disorder (ADHD) is a common neuro-developmental disorder that often persists into adulthood. Moreover, it is frequently accompanied by bipolar disorder (BD) as well as borderline personality disorder (BPD). It is unclear whether these disorders share underlying pathomechanisms, given that all three are characterized by alterations in affective states, either long or short-term. BD is characterized by infrequent but intense mood shifts, while ADHD and BPD involve more dynamic emotional fluctuations. It is yet to be determined whether these disorders represent distinct phenomena or different points on a spectrum of affective dysregulation.
This study seeks to distinguish the emotional dysregulation of BPD, ADHD, and BD by using digital phenotyping, a measurement burst electronic-diary method with different sampling rates, and accelerometry to measure participants' activity. Our study will include 480 participants aged 14 to 50 (120 each from BPD, ADHD, BD, and healthy control groups) from five European sites. Participants' smartphones will provide continuous data on their digital phenotypes, i.e., by indicators of physical activity and communication, for one year, along with daily evening ratings of mood and sleep. Moreover, five intensive measurement periods of five days each, called measurement bursts, will occur throughout the year, with electronic diaries asking participants to report on mood, self-esteem, impulsivity, life events, social interactions, and dysfunctional behaviors ten times a day. Moreover, participants will wear activity sensors during the five measurement bursts. Statistical analysis aims to identify whether affective dysregulation aspects share or differ across disorders. Specifically, data analysis aims to investigate the differences in parameters of affect fluctuation such as attractor strength and variability between disorders and to test the association of genetic risk factors for psychiatric disorders and resilience factors with critical parameters of affect modulation.
The results of this study offer the potential to link patients' external exposures with their affective state, reduce misdiagnosis, and determine the best timing for therapeutic interventions. Potential limitations of the study include insufficient recruitment of patients and drop-outs due to various protocol violations.
Study code: DRKS00028917, registered 27.07.2022, https://drks.de/search/de/trial/DRKS00028917 .
注意力缺陷多动障碍（ADHD）是一种常见的神经发育障碍，常持续至成年期。此外，它还经常伴有双相情感障碍（BD）以及边缘性人格障碍（BPD）。鉴于这三种疾病均以情感状态的改变为特征，无论是长期还是短期，目前尚不清楚它们是否具有共同的潜在发病机制。双相情感障碍的特征是情绪波动不频繁但强烈，而注意力缺陷多动障碍和边缘性人格障碍则涉及更动态的情绪波动。这些疾病是代表不同的现象还是情感失调谱上的不同点，仍有待确定。
本研究旨在通过数字表型分析来区分边缘性人格障碍、注意力缺陷多动障碍和双相情感障碍的情绪失调，数字表型分析是一种采用不同采样率的测量突发电子日记法，并使用加速度计来测量参与者的活动。我们的研究将纳入来自欧洲五个地点的480名年龄在14至50岁之间的参与者（边缘性人格障碍、注意力缺陷多动障碍、双相情感障碍和健康对照组各120名）。参与者的智能手机将在一年内持续提供有关其数字表型的数据，即通过身体活动和通信指标，以及每日晚间的情绪和睡眠评分。此外，全年将有五个为期五天的密集测量期，称为测量突发期，在此期间电子日记会要求参与者每天报告十次情绪、自尊、冲动性、生活事件、社交互动和功能失调行为。此外，参与者在五个测量突发期内将佩戴活动传感器。统计分析旨在确定情感失调方面在不同疾病之间是相同还是不同。具体而言，数据分析旨在研究情感波动参数（如吸引子强度和变异性）在不同疾病之间的差异，并测试精神疾病的遗传风险因素和复原力因素与情感调节关键参数之间的关联。
本研究结果有可能将患者的外部暴露与他们的情感状态联系起来，减少误诊，并确定治疗干预的最佳时机。该研究的潜在局限性包括患者招募不足以及因各种违反方案的情况导致的退出。
研究代码：DRKS00028917，于2022年7月27日注册，https://drks.de/search/de/trial/DRKS00028917 。
