The association between mixed symptoms, irritability and functioning measured using smartphones in bipolar disorder.
OBJECTIVE
To (i) validate patient-evaluated mixed symptoms and irritability measured using smartphones against clinical evaluations; (ii) investigate associations between mixed symptoms and irritability with stress, quality of life and functioning, respectively, in patients with bipolar disorder.


METHODS
A total of 84 patients with bipolar disorder used a smartphone-based system for daily evaluation of mixed symptoms and irritability for nine months. Clinically evaluated symptoms, stress, quality of life and clinically rated functioning were collected multiple times during follow-up.


RESULTS
Patients presented mild affective symptoms. Patient-reported mixed symptoms and irritability correlated with clinical evaluations. In analyses including confounding factors there was a statistically significant association between both mixed symptoms and irritability and stress (P < 0.0001) and between irritability and both quality of life and functioning (P < 0.0001) respectively. There was no association between mixed mood and both quality of life and functioning.


CONCLUSION
Mixed symptoms and irritability can be validly self-reported using smartphones in patients with bipolar disorder. Mixed symptoms and irritability are associated with increased stress even during full or partial remission. Irritability is associated with decreased quality of life and functioning. The findings emphasize the clinical importance of identifying inter-episodic symptoms including irritability pointing towards smartphones as a valid tool.
['Faurholt-Jepsen|M|M|', 'Frost|M|M|', 'Christensen|E M|EM|', 'Bardram|J E|JE|', 'Vinberg|M|M|', 'Kessing|L V|LV|']
D000328:Adult D000339:Affect D000342:Affective Symptoms D001714:Bipolar Disorder D003718:Denmark D005260:Female D006801:Humans D007508:Irritable Mood D008297:Male D008875:Middle Aged D011569:Psychiatric Status Rating Scales D011788:Quality of Life D057566:Self Report D000068997:Smartphone D013315:Stress, Psychological
mixed symptoms irritability smartphone bipolar disorder