A Network Approach to Bipolar Symptomatology in Patients with Different Course Types
A Network Approach to Bipolar Symptomatology in Patients with Different Course Types
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DOI：
10.1371/journal.pone.0141420
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发表时间：
2015-10-27
期刊：
影响因子：
3.7
通讯作者：
Spijker, A. T.
中科院分区：
文献类型：
--
作者：
Koenders, M. A.;de Kleijn, R.;Spijker, A. T.
双相情感障碍（BD）患者的纵向情绪过程是高度可变的。未来病程的最强预测因素之一是过去的病程，这意味着随着时间的推移，出现特定症状模式的脆弱性相当一致。因此，我们调查了不同纵向病程类型的BD患者是否具有典型特征的症状相关网络。为此，我们使用了网络分析，一种在精神病学领域相当新颖的方法。方法基于2年每月生命图表，将125例具有完整2年数据的患者分为3组：轻度受损（n = 47）、主要抑郁（n = 42）和循环过程（n = 36）。症状之间的关联被定义为Young躁狂评定量表（YMRS）和抑郁症状快速量表（QIDS）每对项目之间的分组斯皮尔曼等级相关系数。加权症状网络和中心性措施之间进行了比较three groups.ResultsThe加权网络显着不同的三组之间，躁狂和抑郁的症状是最强烈的相互联系的循环组。具有最高中心性且相互关联性最强的症状在病程组中也存在差异;稳定组的中心症状是情绪升高和言语增加，抑郁组的中心症状是自尊丧失和精神迟钝，结论不同纵向病程类型双相情感障碍患者以最严重症状时间点为基础的症状网络具有显著性差异不同.这一发现及其影响的临床解释进行了讨论。
ObjectiveThe longitudinal mood course is highly variable among patients with bipolar disorder(BD). One of the strongest predictors of the future disease course is the past disease course, implying that the vulnerability for developing a specific pattern of symptoms is rather consistent over time. We therefore investigated whether BD patients with different longitudinal course types have symptom correlation networks with typical characteristics. To this end we used network analysis, a rather novel approach in the field of psychiatry.MethodBased on two-year monthly life charts, 125 patients with complete 2 year data were categorized into three groups: i.e., a minimally impaired (n = 47), a predominantly depressed (n = 42) and a cycling course (n = 36). Associations between symptoms were defined as the groupwise Spearman's rank correlation coefficient between each pair of items of the Young Mania Rating Scale (YMRS) and the Quick Inventory of Depressive Symptomatology (QIDS). Weighted symptom networks and centrality measures were compared among the three groups.ResultsThe weighted networks significantly differed among the three groups, with manic and depressed symptoms being most strongly interconnected in the cycling group. The symptoms with top centrality that were most interconnected also differed among the course group; central symptoms in the stable group were elevated mood and increased speech, in the depressed group loss of self-esteem and psychomotor slowness, and in the cycling group concentration loss and suicidality.ConclusionSymptom networks based on the timepoints with most severe symptoms of bipolar patients with different longitudinal course types are significantly different. The clinical interpretation of this finding and its implications are discussed.