Mood instability in bipolar disorder type I versus type II-continuous daily electronic self-monitoring of illness activity using smartphones.
BACKGROUND
A substantial proportion of patients with bipolar disorder remain symptomatic during inter-episode periods, and mood instability is associated with high risk of relapse and hospitalization. Few studies have investigated long-term daily illness activity and none has compared bipolar type I and II using daily data. The objectives were to investigate differences in daily illness activity between bipolar disorder type I and II.


METHODS
A smartphone-based system for self-monitoring was developed. A total of 33 patients treated in a mood clinic used the system for daily self-monitoring during a median period of 310 days [IQR 189; 437]. Data presented summarize over 8500 observations.


RESULTS
Patients with bipolar disorder type II (n=20), compared to patients with bipolar disorder type I (n=13), experienced a significant lower mean level of mood on a scale from -3; +3 (-0.54 (95% CI: -0.74; -0.35) versus -0.19 (95% CI: -0.35; -0.02), p=0.02), less time euthymic (51.0% (95% CI: 36.4; 65.7) versus 74.5% (95% CI: 62.4; 86.7), p=0.03) and a higher proportion of time with depressive symptoms (45.1% (95% CI: 30.6; 59.5) versus 18.8% (95% CI: 6.9; 30.7), p=0.01). The proportion of time spent with (hypo)manic symptoms did not differ (2.7% (95% CI: 0.1; 5.5) versus 5.5% (95% CI: 3.1; 7.8), p=0.17).


CONCLUSIONS
Patients received different types, doses and combinations of psychopharmacological treatment.


CONCLUSIONS
Euthymia was obtained for a substantial proportion of time in patients with bipolar disorder type I, but despite on-going treatment only for half of the time for patients with bipolar disorder type II. This emphasizes the need for improving treatment strategies for bipolar disorder type II.
Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark. Electronic address: maria@faurholt-jepsen.dk.
Maria
M
Faurholt-Jepsen
Department of Basic Sciences and Environment, Faculty of Life Sciences, University of Copenhagen, Denmark.
Christian
C
Ritz
The Pervasive Interaction Laboratory (PIT Lab), IT University of Copenhagen, Copenhagen, Denmark.
Mads
M
Frost
Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Rie Lambæk
RL
Mikkelsen
Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Ellen
E
Margrethe Christensen
The Pervasive Interaction Laboratory (PIT Lab), IT University of Copenhagen, Copenhagen, Denmark.
Jakob
J
Bardram
Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Maj
M
Vinberg
Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Lars Vedel
LV
Kessing
D000328:Adult; D000339:Affect; D001714:Bipolar Disorder / Q000523:psychology*; D003527:Cyclothymic Disorder / Q000523:psychology; D003863:Depression; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012647:Self-Assessment; D000068997:Smartphone
Bipolar disorder; Daily electronic self-monitoring; Mood instability; Smartphone; Summary indexes on illness activity