Vidal Nathan, Brunet-Gouet Eric, Frileux Solène, Aubin Valérie, Belzeaux Raoul, Courtet Philippe, D'Amato Thierry, Dubertret Caroline, Etain Bruno, Gard Sebastien, Haffen Emmanuel, Januel Dominique, Leboyer Marion, Lefrere Antoine, Llorca Pierre-Michel, Marlinge Emeline, Olié Emilie, Polosan Mircea, Schwan Raymund, Walter Michel, Passerieux Christine, Roux Paul
Fondation FondaMental, Créteil, France.
DisAP-DevPsy-CESP, INSERM UMR1018, Centre Hospitalier de Versailles; Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines, Villejuif, France.
Depress Anxiety. 2024 Oct 24;2024:3375145. doi: 10.1155/2024/3375145. eCollection 2024.
Bipolar disorders (BD) are characterized by mood symptoms that can worsen medication side effects. We aimed to study the association between residual mood signs and self-reported side effects in the euthymic phase of BD. We assessed residual mood signs using the Montgomery-Asberg Depression Rating scale (MADRS) and Young Mania Rating scale (YMRS) and self-reported side effects using the Patient-Rated Inventory of Side Effects (PRISE-M) for 880 males and 1369 females with BD. We conducted a network analysis to test the associations between 52 items of the three scales for males and females separately. We then identified clusters of nodes that fit the networks well. We report only positive associations between residual mood signs and side effects. An elevated mood (YMRS) in females and increased energy (YMRS) in males were central nodes, strongly influencing the development of additional mood symptoms and side effects. Furthermore, we identified three clusters of nodes in both sexes: (1) a "mood cluster", including most YMRS and MADRS items and the PRISE-M items evaluating sedation, sleep, and restlessness, (2) a cluster of nonsexual side effects (mostly PRISE-M items), and (3) a cluster of sexual side effects. In both sexes, we identified bridge nodes that may favor the communication between mood and side effects, namely palpitations (PRISE-M) and agitation (PRISE-M). The results justify the particular attention of practitioners to monitor elevated moods or increased energy to try to reduce self-reported side effects and other residual mood symptoms in the euthymic phase of BD. Our findings suggest that clinicians could consider patient-reported loss of energy, difficulty in falling asleep, and restlessness as mood symptoms rather than medications' side effects. Palpitations and agitation may contribute to the development of additional mood symptoms or somatic complaints.
双相情感障碍（BD）的特征是情绪症状，这些症状会加重药物副作用。我们旨在研究BD缓解期残余情绪体征与自我报告的副作用之间的关联。我们使用蒙哥马利-阿斯伯格抑郁评定量表（MADRS）和杨氏躁狂评定量表（YMRS）评估残余情绪体征，并使用患者自评副作用量表（PRISE-M）对880名男性和1369名女性BD患者进行自我报告的副作用评估。我们分别对男性和女性进行了网络分析，以测试三个量表的52个项目之间的关联。然后，我们确定了与网络拟合良好的节点簇。我们只报告了残余情绪体征与副作用之间的正相关。女性情绪高涨（YMRS）和男性精力增加（YMRS）是中心节点，强烈影响其他情绪症状和副作用的发展。此外，我们在两性中都确定了三个节点簇：（1）“情绪簇”，包括大多数YMRS和MADRS项目以及评估镇静、睡眠和不安的PRISE-M项目；（2）非性副作用簇（主要是PRISE-M项目）；（3）性副作用簇。在两性中，我们都确定了可能有利于情绪与副作用之间交流的桥梁节点，即心悸（PRISE-M）和激动（PRISE-M）。这些结果证明了从业者应特别关注监测情绪高涨或精力增加，以试图减少BD缓解期自我报告的副作用和其他残余情绪症状。我们的研究结果表明，临床医生可以将患者报告的精力丧失、入睡困难和不安视为情绪症状，而非药物副作用。心悸和激动可能会导致更多情绪症状或躯体不适的发展。
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