Mood instability metrics to stratify individuals and measure outcomes in bipolar disorder

He, H. et al. Trends in the incidence and DALYs of bipolar disorder at global, regional, and national levels: results from the Global Burden of Disease Study 2017. J. Psychiatr. Res. 125, 96–105 (2020).Article 
PubMed 

Google Scholar 
Yocum, A. K., Friedman, E., Bertram, H. S., Han, P. & McInnis, M. G. Comparative mortality risks in two independent bipolar cohorts. Psychiatry Res. 330, 115601 (2023).Article 
PubMed 

Google Scholar 
Bauer, M. et al. Areas of uncertainties and unmet needs in bipolar disorders: clinical and research perspectives. Lancet Psychiatry 5, 930–939 (2018).Article 
PubMed 

Google Scholar 
Henry, C. et al. Affective instability and impulsivity in borderline personality and bipolar II disorders: similarities and differences. J. Psychiatr. Res. 35, 307–312 (2001).Article 
PubMed 

Google Scholar 
Bauer, M. et al. Subsyndromal mood symptoms: a useful concept for maintenance studies of bipolar disorder? Psychopathology 43, 1–7 (2009).Article 
PubMed 

Google Scholar 
Burdick, K. E. et al. Predictors of functional impairment in bipolar disorder: results from 13 cohorts from seven countries by the global bipolar cohort collaborative. Bipolar Disord. 24, 709–719 (2022).Article 
PubMed 
PubMed Central 

Google Scholar 
Sperry, S. H. & Kwapil, T. R. Bipolar spectrum psychopathology is associated with altered emotion dynamics across multiple timescales. Emotion 22, 627 (2022).Article 
PubMed 

Google Scholar 
Cochran, A.L., Schultz, A., McInnis, M.G. & Forger, D.B. in Computational Neurology and Psychiatry Vol. 6 (eds Érdi, P., Sen Bhattacharya, B. & Cochran, A.) pp. 315–341 (Springer, 2017).Bonsall, M. B., Wallace-Hadrill, S. M., Geddes, J. R., Goodwin, G. M. & Holmes, E. A. Nonlinear time-series approaches in characterizing mood stability and mood instability in bipolar disorder. Proc. Royal Soc. B 279, 916–924 (2012).Article 

Google Scholar 
Henry, C. et al. Affective lability and affect intensity as core dimensions of bipolar disorders during euthymic period. Psychiatry Res. 159, 1–6 (2008).Article 
PubMed 

Google Scholar 
Faurholt-Jepsen, M. et al. Mood instability and activity/energy instability in patients with bipolar disorder according to day-to-day smartphone-based data—an exploratory post hoc study. J. Affect. Disord. 334, 83–91 (2023).Article 
PubMed 

Google Scholar 
Faurholt-Jepsen, M. et al. Differences in mood instability in patients with bipolar disorder type I and II: a smartphone-based study. Int. J. Bipolar Disord. 7, 1–8 (2019).Article 
PubMed 
PubMed Central 

Google Scholar 
Sperry, S. H., Walsh, M. A. & Kwapil, T. R. Emotion dynamics concurrently and prospectively predict mood psychopathology. J. Affect. Disord. 261, 67–75 (2020).Article 
PubMed 

Google Scholar 
Gershon, A. & Eidelman, P. Inter-episode affective intensity and instability: predictors of depression and functional impairment in bipolar disorder. J. Behav. Ther. Exp. Psychiatry 46, 14–18 (2015).Article 
PubMed 

Google Scholar 
Faurholt‐Jepsen, M. et al. Is smartphone‐based mood instability associated with stress, quality of life, and functioning in bipolar disorder? Bipolar Disord. 21, 611–620 (2019).Article 
PubMed 

Google Scholar 
Strejilevich, S. et al. Mood instability and functional recovery in bipolar disorders. Acta Psychiatr. Scand. 128, 194–202 (2013).Article 
PubMed 

Google Scholar 
Kessing, L. V. & Faurholt-Jepsen, M. Mood instability—a new outcome measure in randomised trials of bipolar disorder? Eur. Neuropsychopharmacol. 58, 39–41 (2022).Article 
PubMed 

Google Scholar 
McInnis, M. G. et al. Cohort profile: the Heinz C. Prechter longitudinal study of bipolar disorder. Int. J. Epidemiol. 47, 28–2 (2018).Article 
PubMed 

Google Scholar 
Yocum, A. K. et al. Cohort profile update: the Heinz C. Prechter longitudinal study of bipolar disorder. Int. J. Epidemiol. https://doi.org/10.1093/ije/dyad109 (2023).Kroenke, K., Spitzer, R. L. & Williams, J. B. W. The PHQ-9: validity of a brief depression severity measure. J. Gen. Intern. Med. 16, 606–613 (2001).Article 
PubMed 
PubMed Central 

Google Scholar 
Altman, E. G., Hedeker, D., Peterson, J. L. & Davis, J. M. The Altman self-rating mania scale. Biol. Psychiatry 42, 948–955 (1997).Article 
PubMed 

Google Scholar 
Spitzer, R. L., Kroenke, K., Williams, J. B. W. & Löwe, B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch. Intern. Med. 166, 1092–1097 (2006).Article 
PubMed 

Google Scholar 
Ware, J. E., Kosinski, M. & Keller, S. D. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med. Care 34, 220–233 (1996).Article 
PubMed 

Google Scholar 
Fisher, A. J. & Newman, M. G. Reductions in the diurnal rigidity of anxiety predict treatment outcome in cognitive behavioral therapy for generalized anxiety disorder. Behav. Res. Ther. 79, 46–55 (2016).Article 
PubMed 
PubMed Central 

Google Scholar 
Jahng, S., Wood, P. K. & Trull, T. J. Analysis of affective instability in ecological momentary assessment: indices using successive difference and group comparison via multilevel modeling. Psychol. Methods 13, 354 (2008).Article 
PubMed 

Google Scholar 
Bos, E. H., de Jonge, P. & Cox, R. F. Affective variability in depression: revisiting the inertia–instability paradox. Br. J. Psychol. 110, 814–827 (2019).Article 
PubMed 

Google Scholar 
Hu, D., Kalokerinos, E. K. & Tamir, M. Flexibility or instability? Emotion goal dynamics and mental health. Emotion 24, 1078–1091 (2023).Article 
PubMed 

Google Scholar 
Sperry, S. H. & Kwapil, T. R. Affective dynamics in bipolar spectrum psychopathology: modeling inertia, reactivity, variability, and instability in daily life. J. Affect. Disord. 251, 195–204 (2019).Article 
PubMed 

Google Scholar 
Sperry, S. H. & Kwapil, T. R. Bipolar spectrum psychopathology is associated with altered emotion dynamics across multiple timescales. Emotion 22, 627–640 (2022).Article 
PubMed 

Google Scholar 
Dejonckheere, E. et al. Complex affect dynamics add limited information to the prediction of psychological well-being. Nat. Hum. Behav. 3, 478–491 (2019).Article 
PubMed 

Google Scholar 
Bates, D., Mächler, M., Bolker, B. & Walker, S. Fitting linear mixed-effects models using lme4. J. Stat. Softw. 67, 1–48 (2015).Article 

Google Scholar 
RStudio Integrated Development Environment (Posit Software, 2023).Pressman, S. D., Jenkins, B. N. & Moskowitz, J. T. Positive affect and health: what do we know and where next should we go? Ann. Rev. Psychol. 70, 627–650 (2019).Article 

Google Scholar 
Fisher, A. J. & Woodward, S. H. Cardiac stability at differing levels of temporal analysis in panic disorder, post‐traumatic stress disorder, and healthy controls. Psychophysiology 51, 80–87 (2014).Article 
PubMed 

Google Scholar 
Kroenke, K., Spitzer, R. L., Williams, J. B. & Löwe, B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen. Hosp. Psychiatry 32, 345–359 (2010).Article 
PubMed 

Google Scholar 
Altman, E. Rating scales for mania: is self-rating reliable? J. Affect. Disord. 50, 283–286 (1998).Article 
PubMed 

Google Scholar 
Hageman, W. J. & Arrindell, W. A. A further refinement of the reliable change (RC) index by improving the pre-post difference score: introducing RCID. Behav. Res. Ther. 31, 693–700 (1993).Article 
PubMed 

Google Scholar 
Singh, B. et al. Patterns of pharmacotherapy for bipolar disorder: a GBC survey. Bipolar Disord. 26, 22–32 (2023).Article 
PubMed 

Google Scholar 
Zandi, P. P. et al. Development of the national network of depression centers mood outcomes program: a multisite platform for measurement-based care. Psychiatr. Serv. 71, 456–464 (2020).Article 
PubMed 

Google Scholar 
Mower Provost, E. et al. Emotion recognition in the real-world: passively collecting and estimating emotions from natural speech data of individuals with bipolar disorder. IEEE Trans. Affect. Comput. https://doi.org/10.1109/TAFFC.2024.3407683 (2024).Price, G. D., Heinz, M. V., Song, S. H., Nemesure, M. D. & Jacobson, N. C. Using digital phenotyping to capture depression symptom variability: detecting naturalistic variability in depression symptoms across one year using passively collected wearable movement and sleep data. Transl. Psychiatry 13, 381 (2023).Article 
PubMed 
PubMed Central 

Google Scholar 
Fang, Y., Forger, D. B., Frank, E., Sen, S. & Goldstein, C. Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians. NPJ Digit. Med. 4, 28 (2021).Article 
PubMed 
PubMed Central 

Google Scholar 
Lazarus, G., Song, J., Crawford, C.M. & Fisher, A.J. (2021). in Affect Dynamics (eds Waugh, C.E. & Kuppens, P.) pp 95–116 (Springer, 2021).Nurnberger, J. I. Jr. et al. Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetics Initiative. Arch. Gen. Psychiatry 51, 849–859 (1994).Article 
PubMed 

Google Scholar 
Harris, P. A. et al. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J. Biomed. Inform. 42, 377–381 (2009).Article 
PubMed 

Google Scholar 
Harris, P. A. et al. The REDCap consortium: building an international community of software partners. J. Biomed. Inform. 95, 103208 (2019).Article 
PubMed 
PubMed Central 

Google Scholar 
Kim, H., McInnis, M. & Sperry, S. H. Longitudinal dynamics between anxiety and depression in bipolar spectrum disorders. J. Psychopathol. Clin. Sci. 133, 129–139 (2024).Article 
PubMed 

Google Scholar 

Hot Topics

Related Articles