Actigraphic patterns, impulsivity and mood instability in bipolar disorder, borderline personality disorder and healthy controls

Abstract

Actigraphic patterns, impulsivity and mood instability in bipolar disorder, borderline personality disorder and healthy controls.Objectives: To differentiate the relation between the structure and timing of rest-activity patterns and symptoms of impulsivity and mood instability in bipolar disorder (BD), borderline personality disorder (BPD) and healthy controls (HC). Methods: Eighty-seven participants (31 BD, 21 BPD and 35 HC) underwent actigraph monitoring for 28 days as part of the Automated Monitoring of Symptom Severity (AMoSS) study. Impulsivity was assessed at study entry using the BIS-11. Mood instability was subsequently longitudinally monitored using the digital Mood Zoom questionnaire. Results: BPD participants show several robust and significant correlations between non-parametric circadian rest-activity variables and worsened symptoms. Impulsivity was associated with low interdaily stability (r = À0.663) and weak amplitude (r = À0.616). Mood instability was associated with low interdaily stability (r = À0.773), greater rhythm fragmentation (r = 0.662), weak amplitude (r = À0.694) and later onset of daily activity (r = 0.553). These associations were not present for BD or HCs. Classification analysis using actigraphic measures determined that later L5 onset reliably distinguished BPD from BD and HC but did not sufficiently discriminate between BD and HC. Conclusions: Rest-activity pattern disturbance indicative of perturbed sleep and circadian function is an important predictor of symptom severity in BPD. This appears to validate the greater subjective complaints of BPD individuals that are sometimes regarded as exaggerated by clinicians. We suggest that treatment strategies directed towards improving sleep and circadian entrainment may in the future be investigated in BPD. Significant Outcomes• Objectively determined rest-activity patterns are strongly correlated with worsened symptoms of impulsivity and longitudinally monitored mood instability in BPD.• Sleep and circadian features may impact on the chronicity of symptoms in BPD above BD and HCs.• Future studies targeting rest-activity pattern modification in BPD are indicated. Limitations• Sample heterogeneity present for gender and number of unemployed individuals. • Relative small sample size restricts stratification for medication and comorbid diagnoses.

Disturbances of Continuous Sleep and Circadian Rhythms Account for Behavioral Difficulties in Children with Autism Spectrum Disorder

“…While this approximation may be adequate in the population in which they were conceived, they are not necessarily fitting in all population. Indeed, they were initially investigated in adults with Alzheimer's disease [48] and were later used in other populations such as in Parkinson's disease, bipolar disorder or in healthy infants [70][71][72]. There are different possible reasons for which the NPCRA might not correctly identify the circadian rhythm of young children.…”

Blood pressure in bipolar disorder: evidence of elevated pulse pressure and associations between mean pressure and mood instability

“…Future studies that employ higher frequency BPV sampling methods such as via ABPM are required to thoroughly assess normal circadian fluctuation and finer scale autonomic oscillations of BP in psychiatric groups. This is particularly relevant in the context of previous findings of differential circadian function and autonomic regulation and their influence upon mood instability in BD and BPD (Carr et al 2018;McGowan et al 2019McGowan et al , 2020.…”

فاعلیة برنامج إرشادی سلوکی جدلی فی خفض السلوک الاندفاعی لدى طلاب الجامعة ذوی أعراض اضطراب الشخصیة الحدیة

“…(Keefe, et al, 2020;Guillén Botella, et al, 2020;Mohamadizadeh et al, 2018) . Claréus, et al, 2017;D'Orta, et al, 2015;Zhang, et al, Claréus, et al, 2017;Teese, et al, 2020;Zhang, et al, (McGowan, Goodwin, Bilderbeck & Saunders, 2020;Richard-Lepouriel et al, 2019;Svěrák, Linhartova, Fiala, Kašpárek & Ustohal, 2018 (Benson, Donnellan, & Morey, 2017;Goldhammer, Crall & Keuroghlian, 2019;Hamdullahpur, 2018;Sher, Rutter, New, Siever & Hazlett, 2019 ُْٔ ‫ا٫ٍزغبثخ‬ ‫ً٤ل٤خ‬ ‫ؽٍٞ‬ ‫ٓوٖٞكح‬ ‫ف٤بهاد‬ ‫٫رقبم‬ ‫اُلوٕخ‬ ‫رلبػِ٤خ‬ ‫رٌٕٞ‬ ‫إٔ‬ ٖٓ ً ‫ثل٫‬ ‫اُؾ٤بح‬ ‫بًَ‬ Linehan, 1993a-b) . ٕ -‫ػِ٠‬ ‫ٝاُؾلبظ‬ ،٫ ‫هُٞٚ‬ ‫أٝ‬ ‫أُوء‬ ‫٣و٣لٙ‬ ‫ػٔب‬ ‫اَُإاٍ‬ ‫ٜٓبهاد‬ ‫ّبُخ‬ ‫اُلؼ‬ ‫اُج٤ْ٘قٖ٤خ‬ ‫أُٜبهاد‬ ٖ َّ ‫رزٚٔ‬ ‫ا٫ٙطواة‬ ‫مٝ١‬ ‫ريٝ٣ل‬ ‫ٛو٣ن‬ ‫ػٖ‬ ‫ٝمُي‬ ‫اُناد؛‬ ‫اؽزواّ‬ ‫ػِ٠‬ ‫ٝاُؾلبظ‬ ‫اُؼ٬هخ،‬ ‫ُزٞع٤ٚ‬ ‫ٓ٘ظْ‬ ‫ثَ٘ن‬ ‫ٜٓبهارْٜ‬ ‫ٓغ‬ ‫رزلافَ‬ ‫اُز٢‬ ‫اُؼ٬هبد‬ ‫ؽٍٞ‬ ‫اُقطأ‬ ‫أُؼزولاد‬ ‫رؾل١‬ ‫٣زؼِٕٔٞ‬ ‫ًٔب‬ ‫اُج٤ْ٘قٖ٤خ،‬ ‫رلبػ٬رْٜ‬ ‫اُغل٣لح‬ ‫زؼِٔخ‬ ُ ‫أُ‬ ‫ُِٜٔبهاد‬ ‫اٍزقلآْٜ‬ ‫رؼٞم‬ ‫هل‬ ‫اُز٢‬ ‫اُؼٞآَ‬ ‫ًٝنُي‬ ‫اُج٤ْ٘قٖ٤خ،‬ , Linehan, 1993a) .…”