Specificity of affective dynamics of bipolar and major depressive disorder

Authors

Emma K. Stapp, Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
Vadim Zipunnikov, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Andrew Leroux, Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, Colorado, USA.
Lihong Cui, Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
Mathilde M. Husky, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France.
Debangan Dey, Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
Kathleen R. Merikangas, Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland, USA.

Document Type

Journal Article

Publication Date

8-13-2023

Journal

Brain and behavior

DOI

10.1002/brb3.3134

Keywords

affective symptoms; bipolar disorder; depressive disorder; ecological momentary assessment; emotions; major; structural equation modeling

Abstract

OBJECTIVE: Here, we examine whether the dynamics of the four dimensions of the circumplex model of affect assessed by ecological momentary assessment (EMA) differ among those with bipolar disorder (BD) and major depressive disorder (MDD). METHODS: Participants aged 11-85 years (n = 362) reported momentary sad, anxious, active, and energetic dimensional states four times per day for 2 weeks. Individuals with lifetime mood disorder subtypes of bipolar-I, bipolar-II, and MDD derived from a semistructured clinical interview were compared to each other and to controls without a lifetime history of psychiatric disorders. Random effects from individual means, inertias, innovation (residual) variances, and cross-lags across the four affective dimensions simultaneously were derived from multivariate dynamic structural equation models. RESULTS: All mood disorder subtypes were associated with higher levels of sad and anxious mood and lower energy than controls. Those with bipolar-I had lower average activation, and lower energy that was independent of activation, compared to MDD or controls. However, increases in activation were more likely to perpetuate in those with bipolar-I. Bipolar-II was characterized by higher lability of sad and anxious mood compared to bipolar-I and controls but not MDD. Compared to BD and controls, those with MDD exhibited cross-augmentation of sadness and anxiety, and sadness blunted energy. CONCLUSION: Bipolar-I is more strongly characterized by activation and energy than sad and anxious mood. This distinction has potential implications for both specificity of intervention targets and differential pathways underlying these dynamic affective systems. Confirmation of the longer term stability and generalizability of these findings in future studies is necessary.

APA Citation

Stapp, Emma K.; Zipunnikov, Vadim; Leroux, Andrew; Cui, Lihong; Husky, Mathilde M.; Dey, Debangan; and Merikangas, Kathleen R., "Specificity of affective dynamics of bipolar and major depressive disorder" (2023). GW Authored Works. Paper 3258.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3258

Department

Epidemiology