Abstract
BackgroundMood instability in bipolar disorder is associated with a risk of relapse. This study investigated differences in mood instability between patients with bipolar disorder type I and type II, which previously has been sparingly investigated.MethodsPatients with bipolar disorder type I (n = 53) and type II (n = 31) used a daily smartphone-based self-monitoring system for 9 months. Data in the present reflect 15.975 observations of daily collected smartphone-based data on patient-evaluated mood.ResultsIn models adjusted for age, gender, illness duration and psychopharmacological treatment, patients with bipolar disorder type II experienced more mood instability during depression compared with patients with bipolar disorder type I (B: 0.27, 95% CI 0.007; 0.53, p = 0.044), but lower intensity of manic symptoms. Patients with bipolar disorder type II did not experience lower mean mood or higher intensity of depressive symptoms compared with patients with bipolar disorder type I.ConclusionsCompared to bipolar disorder type I, patients with bipolar disorder type II had higher mood instability for depression. Clinically it is of importance to identify these inter-episodic symptoms. Future studies investigating the effect of treatment on mood instability measures are warranted.Trial registration NCT02221336
Highlights
Mood instability in bipolar disorder is associated with a risk of relapse
In this study including 33 patients with bipolar disorder, the patients with bipolar disorder type II spend less time euthymic, a higher proportion of time with depressive symptoms and experienced higher mood instability for depression compared with patients with bipolar disorder type I (Faurholt-Jepsen et al 2015a)
We hypothesized that patients with bipolar disorder type II had lower mean mood level, spend less time euthymic, a higher proportion of time with depressive symptoms, experienced higher instability for depression, i.e. more fluctuations in self-monitored depressive mood, and experienced higher levels and intensity of depressive symptoms compared with patients with bipolar disorder type I
Summary
Mood instability in bipolar disorder is associated with a risk of relapse. This study investigated differ‐ ences in mood instability between patients with bipolar disorder type I and type II, which previously has been spar‐ ingly investigated. In this study (the MONARCA I trial) including 33 patients with bipolar disorder, the patients with bipolar disorder type II spend less time euthymic, a higher proportion of time with depressive symptoms and experienced higher mood instability for depression compared with patients with bipolar disorder type I (Faurholt-Jepsen et al 2015a). Apart from this previous pilot study by the authors, no study has investigated differences in mood instability between patients with bipolar disorder type I and bipolar disorder type II using fine-grained daily electronic data. We hypothesized that patients with bipolar disorder type II had lower mean mood level, spend less time euthymic, a higher proportion of time with depressive symptoms, experienced higher instability for depression, i.e. more fluctuations in self-monitored depressive mood, and experienced higher levels and intensity of depressive symptoms compared with patients with bipolar disorder type I
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