Variability in phase and amplitude of diurnal rhythms is related to variation of mood in bipolar and borderline personality disorder

Abstract

Variable mood is an important feature of psychiatric disorders. However, its measurement and relationship to objective measureas of physiology and behaviour have rarely been studied. Smart-phones facilitate continuous personalized prospective monitoring of subjective experience and behavioural and physiological signals can be measured through wearable devices. Such passive data streams allow novel estimates of diurnal variability. Phase and amplitude of diurnal rhythms were quantified using new techniques that fitted sinusoids to heart rate (HR) and acceleration signals. We investigated mood and diurnal variation for four days in 20 outpatients with bipolar disorder (BD), 14 with borderline personality disorder (BPD) and 20 healthy controls (HC) using a smart-phone app, portable electrocardiogram (ECG), and actigraphy. Variability in negative affect, positive affect, and irritability was elevated in patient groups compared with HC. The study demonstrated convincing associations between variability in subjective mood and objective variability in diurnal physiology. For BPD there was a pattern of positive correlations between mood variability and variation in activity, sleep and HR. The findings suggest BPD is linked more than currently believed with a disorder of diurnal rhythm; in both BPD and BD reducing the variability of sleep phase may be a way to reduce variability of subjective mood.

Group-Personalized Regression Models for Predicting Mental Health Scores From Objective Mobile Phone Data Streams: Observational Study

“…By contrast, there is very little overlap between healthy control and borderline personality disorder group membership. This finding broadly aligns with other subjective measures of mental state, sampled much more frequently than weekly, which show a gradient of abnormal mood where healthy control<bipolar disorder<borderline personality disorder [ 19 , 20 ]. How more frequent sampling would combine with geolocation data is an important future question.…”

“…The app recorded individuals’ activity levels, geographic movements (described below), light exposure, and social interaction. We also collected physiological data during some parts of the study, as presented by Carr et al [ 19 , 20 ]. More details about the study design are available in our previous work [ 17 ].…”

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

“…Recently, we identified desynchronised patterns of heart rate, activity and sleep, in participants with BD and BPD (14) and correspondingly, reported an association between desynchrony and differential mood patterns (22). We also demonstrated that individuals with BPD exhibit rest-activity patterns that are suggestive of phase delayed circadian clock function compared with stable BD and healthy controls (23).…”

Sleep differences in the UK between 1974 and 2015: Insights from detailed time diaries

“…Sleep health might also relate to sleep timing (Carr et al, 2018) or the unequal allocation of sleep throughout the week (Wittmann et al, 2006). It is often suggested that any sleep variability is undesirable.…”