Anticipating manic and depressive transitions in patients with bipolar disorder using early warning signals
| Autor: | Fionneke Marijke Bos, Marieke Schreuder, Sandip Varkey George, Bennard Doornbos, Richard Bruggeman, Lian van der Krieke, Bartholomeus C.M. Haarman, M. Wichers, Evelien Snippe |
|---|---|
| Přispěvatelé: | Clinical Cognitive Neuropsychiatry Research Program (CCNP), Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE) |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Psychiatry
INDICATORS DYNAMICS Mobile Health Science & Technology Bipolar disorder Early detection CRITICAL SLOWING-DOWN Complexity Critical transitions Psychiatry and Mental health QUICK INVENTORY MOOD REGULATION mental disorders Dynamical systems Experience sampling methodology Early warning signals Smartphone Single-subject Life Sciences & Biomedicine Ecological momentary assessment CLINICIAN Biological Psychiatry |
| Zdroj: | International Journal of Bipolar Disorders, 10(1):12. SPRINGER HEIDELBERG |
| ISSN: | 2194-7511 |
| Popis: | Background In bipolar disorder treatment, accurate episode prediction is paramount but remains difficult. A novel idiographic approach to prediction is to monitor generic early warning signals (EWS), which may manifest in symptom dynamics. EWS could thus form personalized alerts in clinical care. The present study investigated whether EWS can anticipate manic and depressive transitions in individual patients with bipolar disorder. Methods Twenty bipolar type I/II patients (with ≥ 2 episodes in the previous year) participated in ecological momentary assessment (EMA), completing five questionnaires a day for four months (Mean = 491 observations per person). Transitions were determined by weekly completed questionnaires on depressive (Quick Inventory for Depressive Symptomatology Self-Report) and manic (Altman Self-Rating Mania Scale) symptoms. EWS (rises in autocorrelation at lag-1 and standard deviation) were calculated in moving windows over 17 affective and symptomatic EMA states. Positive and negative predictive values were calculated to determine clinical utility. Results Eleven patients reported 1–2 transitions. The presence of EWS increased the probability of impending depressive and manic transitions from 32-36% to 46–48% (autocorrelation) and 29–41% (standard deviation). However, the absence of EWS could not be taken as a sign that no transition would occur in the near future. The momentary states that indicated nearby transitions most accurately (predictive values: 65–100%) were full of ideas, worry, and agitation. Large individual differences in the utility of EWS were found. Conclusions EWS show theoretical promise in anticipating manic and depressive transitions in bipolar disorder, but the level of false positives and negatives, as well as the heterogeneity within and between individuals and preprocessing methods currently limit clinical utility. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink