TY - JOUR

T1 - Irritability in bipolar disorder and unipolar disorder measured daily using smartphone-based data

T2 - An exploratory post hoc study

AU - Faurholt-Jepsen, Maria

AU - Busk, Jonas

AU - Tønning, Morten Lindberg

AU - Bardram, Jakob Eyvind

AU - Frost, Mads

AU - Vinberg, Maj

AU - Kessing, Lars Vedel

N1 - Publisher Copyright: © 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2023

Y1 - 2023

N2 - Objective: To investigate (i) the proportions of time with irritability and (ii) the association between irritability and affective symptoms and functioning, stress, and quality of life in patients with bipolar disorder (BD) and unipolar depressive disorder (UD). Methods: A total of 316 patients with BD and 58 patients with UD provided self-reported once-a-day data on irritability and other affective symptoms using smartphones for a total of 64,129 days with observations. Questionnaires on perceived stress and quality of life and clinical evaluations of functioning were collected multiple times during the study. Results: During a depressive state, patients with UD spent a significantly higher proportion of time with presence of irritability (83.10%) as compared with patients with BD (70.27%) (p = 0.045). Irritability was associated with lower mood, activity level and sleep duration and with increased stress and anxiety level, in both patient groups (p-values<0.008). Increased irritability was associated with impaired functioning and increased perceived stress (p-values<0.024). In addition, in patients with UD, increased irritability was associated with decreased quality of life (p = 0.002). The results were not altered when adjusting for psychopharmacological treatments. Conclusions: Irritability is an important part of the symptomatology in affective disorders. Clinicians could have focus on symptoms of irritability in both patients with BD and UD during their course of illness. Future studies investigating treatment effects on irritability would be interesting.

AB - Objective: To investigate (i) the proportions of time with irritability and (ii) the association between irritability and affective symptoms and functioning, stress, and quality of life in patients with bipolar disorder (BD) and unipolar depressive disorder (UD). Methods: A total of 316 patients with BD and 58 patients with UD provided self-reported once-a-day data on irritability and other affective symptoms using smartphones for a total of 64,129 days with observations. Questionnaires on perceived stress and quality of life and clinical evaluations of functioning were collected multiple times during the study. Results: During a depressive state, patients with UD spent a significantly higher proportion of time with presence of irritability (83.10%) as compared with patients with BD (70.27%) (p = 0.045). Irritability was associated with lower mood, activity level and sleep duration and with increased stress and anxiety level, in both patient groups (p-values<0.008). Increased irritability was associated with impaired functioning and increased perceived stress (p-values<0.024). In addition, in patients with UD, increased irritability was associated with decreased quality of life (p = 0.002). The results were not altered when adjusting for psychopharmacological treatments. Conclusions: Irritability is an important part of the symptomatology in affective disorders. Clinicians could have focus on symptoms of irritability in both patients with BD and UD during their course of illness. Future studies investigating treatment effects on irritability would be interesting.

KW - bipolar disorder

KW - digital phenotyping

KW - irritability

KW - mobile sensing

KW - unipolar disorder

U2 - 10.1111/acps.13558

DO - 10.1111/acps.13558

M3 - Journal article

C2 - 37094823

AN - SCOPUS:85153488960

VL - 147

SP - 593

EP - 602

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

SN - 0001-690X

IS - 6

ER -