Is smartphone‐based mood instability associated with stress, quality of life, and functioning in bipolar disorder?

Abstract

Objective Mood instability in patients with bipolar disorder has been associated with impaired functioning and risk of relapse. The present study aimed to investigate whether increased mood instability is associated with increased perceived stress and impaired quality of life and functioning in patients with bipolar disorder. Methods A total of 84 patients with bipolar disorder used a smartphone‐based self‐monitoring system on a daily basis for 9 months. Data on perceived stress, quality of life, and clinically rated functioning were collected at five fixed time points for each patient during follow‐up. A group of 37 healthy individuals served as a control comparison of perceived stress, quality of life, and psychosocial functioning. Results The majority of patients presented in full or partial remission. As hypothesized, mood instability was significantly associated with increased perceived stress (B: 10.52, 95% CI: 5.25; 15.77, P < 0.0001) and decreased quality of life (B: −12.17, 95% CI. −19.54; −4.79, P < 0.0001) and functioning (B: −12.04, 95% CI: −19.08; −4.99, P < 0.0001) in patients with bipolar disorder. There were no differences in mood instability according to prescribed psychopharmacological treatment. Compared with healthy individuals, patients reported substantially increased perceived stress and experienced decreased quality of life and decreased functioning based on researcher‐blinded evaluation. Conclusion Mood instability in bipolar disorder is associated with increased perceived stress and decreased quality of life and functioning even during full or partial remission. There is a need to monitor and identify subsyndromal inter‐episodic symptoms. Future studies investigating the effect of treatment on mood instability are highly warranted.

Exploring the Relationship Between Psychiatric Traits and the Risk of Mouth Ulcers Using Bi-Directional Mendelian Randomization

“…For example, ulceration is exacerbated during examination periods and lessened during periods of vacation for students (Scully, 2013). Meanwhile, stress is well known to correlate with mood instability and subjective wellbeing (Schneiderman et al, 2005;Atanes et al, 2015;Berrios et al, 2016;Gillett and Crisp, 2017;Faurholt-Jepsen et al, 2019). Our study suggested that mood instability and subjective wellbeing are causally associated with mouth ulcers using several MR methods.…”

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

“…The core content elements of psychoeducation (to be delivered to all patients) are the content elements shared across the psychological treatments, including improved ability to recognise early warning signs, knowledge about and acceptance of BD, and daily monitoring of mood and sleep (Duffy et al, 2019; Faurholt-Jepsen et al, 2019) (see Table 22 in MDcpg 2015 ). These elements are often conceptualised as part of self-management approaches to BD (Gliddon et al, 2017; Michalak et al, 2019).…”

Mood, activity, and sleep measured via daily smartphone-based self-monitoring in young patients with newly diagnosed bipolar disorder, their unaffected relatives and healthy control individuals

“…Smartphone-based self-monitored data have shown to validly reflect illness activity in patients with BD [15,21,[36][37][38]. Thus, smartphone-based self-monitoring may improve the timeliness in monitoring symptoms, functioning, and fluctuations in symptoms, and might, therefore, be a promising supportive diagnostic tool in individuals where BD is suspected.…”