Day-to-day variability in bipolar disorders

Jackson, Alison Margaret (2006) Day-to-day variability in bipolar disorders. PhD thesis, University of Glasgow.

Abstract

Background. Bipolar disorder is characterised by recurrent acute episodes of mania and
depression with the common occurrence of subsyndromal symptoms between episodes.
Episode recurrence and frequent inter-episode symptoms have made identification of the
factors that influence relapse an important focus for research in bipolar disorder.

Objective. To determine whether dysregulation in bipolar disorder would be exhibited,
outwith acute mania, in day-to-day variability and whether variability was associated with
risk of relapse.

Design. A prospective daily monitoring study was conducted with bipolar disorder and
general population samples. Twenty participants with a bipolar episode experienced in the
previous two years were recruited from a Lithium Clinic. A control group often
participants from the general population were recruited by opportunity sampling.
Main outcome measures. Biological, behaviour, cognition, and affect measures included
self-report measures of behavioural activation/inhibition, social rhythms, self esteem,
positive affect, negative affect, elation, depression and objective actigraph estimation of the
sleep-wake cycle and circadian rhythms.

Results. Lower self esteem, lower positive affect, higher negative affect, higher depression
levels and greater variability in self esteem, night waking and sleep efficiency across 14 days
were evident in bipolar disorder. Survival analyses suggested greater variability in self
esteem and sleep efficiency predicted earlier admission in bipolar disorder.

Conclusions. Greater day-to-day variability in bipolar disorder was observed compared to
the general population. Underlying disturbances in biological, cognition and affect
measures were evident in bipolar disorder. Findings were clinically important since sleep
and self esteem disturbances may be considered as potentially modifiable in reducing risk of
relapse in bipolar disorder.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Subjects: B Philosophy. Psychology. Religion > BF Psychology; R Medicine > R Medicine (General)
• Colleges/Schools: College of Medical Veterinary and Life Sciences
• Supervisor's Name: Scott, Jan, Espie, Colin and Millar, Keith
• Date of Award: 2006
• Depositing User: Ms Anikó Szilágyi
• Unique ID: glathesis:2006-6326
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 07 May 2015 08:25
• Last Modified: 02 May 2018 12:27
• URI: https://theses.gla.ac.uk/id/eprint/6326