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Psychopathologic structure of bipolar disorders: exploring dimensional phenotypes, their relationships, and their associations with bipolar I and II disorders

  • Ji Hyun Baek (a1), Kyooseob Ha (a2) (a3), Yongkang Kim (a4), Young-ah Cho (a1), So Yung Yang (a1), Yujin Choi (a5), Sung-Lee Jang (a5), Taesung Park (a4), Tae Hyon Ha (a6) and Kyung Sue Hong (a1) (a5)...

Abstract

Background

Given its diverse disease courses and symptom presentations, multiple phenotype dimensions with different biological underpinnings are expected with bipolar disorders (BPs). In this study, we aimed to identify lifetime BP psychopathology dimensions. We also explored the differing associations with bipolar I (BP-I) and bipolar II (BP-II) disorders.

Methods

We included a total of 307 subjects with BPs in the analysis. For the factor analysis, we chose six variables related to clinical courses, 29 indicators covering lifetime symptoms of mood episodes, and 6 specific comorbid conditions. To determine the relationships among the identified phenotypic dimensions and their effects on differentiating BP subtypes, we applied structural equation modeling.

Results

We selected a six-factor solution through scree plot, Velicer's minimum average partial test, and face validity evaluations; the six factors were cyclicity, depression, atypical vegetative symptoms, elation, psychotic/irritable mania, and comorbidity. In the path analysis, five factors excluding atypical vegetative symptoms were associated with one another. Cyclicity, depression, and comorbidity had positive associations, and they correlated negatively with psychotic/irritable mania; elation showed positive correlations with cyclicity and psychotic/irritable mania. Depression, cyclicity, and comorbidity were stronger in BP-II than in BP-I, and they contributed significantly to the distinction between the two disorders.

Conclusions

We identified six phenotype dimensions; in addition to symptom features of manic and depressive episodes, various comorbidities and high cyclicity constructed separate dimensions. Except for atypical vegetative symptoms, all factors showed a complex interdependency and played roles in discriminating BP-II from BP-I.

Copyright

Corresponding author

Author for correspondence: Kyung Sue Hong, E-mail: hongks@skku.edu

References

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Ahn, SW, Baek, JH, Yang, SY, Kim, Y, Cho, Y, Choi, Y, Lee, K, Park, T and Hong, KS (2017) Long-term response to mood stabilizer treatment and its clinical correlates in patients with bipolar disorders: a retrospective observational study. International Journal of Bipolar Disorders 5, 24.10.1186/s40345-017-0093-5
Akiskal, HS, Azorin, JM and Hantouche, EG (2003 a) Proposed multidimensional structure of mania: beyond the euphoric-dysphoric dichotomy. Journal of Affective Disorders 73, 718.10.1016/S0165-0327(02)00318-X
Akiskal, HS, Hantouche, EG and Allilaire, JF (2003 b) Bipolar II with and without cyclothymic temperament: ‘dark’ and ‘sunny’ expressions of soft bipolarity. Journal of Affective Disorders 73, 4957.10.1016/S0165-0327(02)00320-8
American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). Arlington, VA: American Psychiatric Publishing.
Bae, M, Lee, K, Baek, JH, Kim, JS, Cho, Y, Ryu, S, Ha, K and Hong, KS (2014) Lifetime experiences of hypomanic symptoms are associated with delayed and irregular sleep-wake cycle and seasonality in non-clinical adult samples. Comprehensive Psychiatry 55, 11111115.10.1016/j.comppsych.2014.02.012
Baek, JH, Park, DY, Choi, J, Kim, JS, Choi, JS, Ha, K, Kwon, JS, Lee, D and Hong, KS (2011) Differences between bipolar I and bipolar II disorders in clinical features, comorbidity, and family history. Journal of Affective Disorders 131, 5967.10.1016/j.jad.2010.11.020
Baek, JH, Eisner, LR and Nierenberg, AA (2014) Epidemiology and course of unipolar mania: results from the national epidemiologic survey on alcohol and related conditions (NESARC). Depression and Anxiety 31, 746755.10.1002/da.22261
Baek, JH, Kim, JS, Kim, MJ, Ryu, S, Lee, K, Ha, K and Hong, KS (2016) Lifetime characteristics of evening-preference and irregular bed-rise time are associated with lifetime seasonal variation of mood and behavior: comparison between individuals with bipolar disorder and healthy controls. Behavioral Sleep Medicine 14, 155168.10.1080/15402002.2014.974179
Bellivier, F, Golmard, JL, Henry, C, Leboyer, M and Schurhoff, F (2001) Admixture analysis of age at onset in bipolar I affective disorder. Archives of General Psychiatry 58, 510512.10.1001/archpsyc.58.5.510
Benazzi, F and Akiskal, HS (2003) The dual factor structure of self-rated MDQ hypomania: energized-activity versus irritable-thought racing. Journal of Affective Disorders 73, 5964.10.1016/S0165-0327(02)00333-6
Burton, CZ, Ryan, KA, Kamali, M, Marshall, DF, Harrington, G, McInnis, MG and Tso, IF (2018) Psychosis in bipolar disorder: does it represent a more ‘severe’ illness? Bipolar Disorder 20, 1826.10.1111/bdi.12527
Charney, AW, Ruderfer, DM, Stahl, EA, Moran, JL, Chambert, K, Belliveau, RA, Forty, L, Gordon-Smith, K, Di Florio, A, Lee, PH, Bromet, EJ, Buckley, PF, Escamilla, MA, Fanous, AH, Fochtmann, LJ, Lehrer, DS, Malaspina, D, Marder, SR, Morley, CP, Nicolini, H, Perkins, DO, Rakofsky, JJ, Rapaport, MH, Medeiros, H, Sobell, JL, Green, EK, Backlund, L, Bergen, SE, Jureus, A, Schalling, M, Lichtenstein, P, Roussos, P, Knowles, JA, Jones, I, Jones, LA, Hultman, CM, Perlis, RH, Purcell, SM, McCarroll, SA, Pato, CN, Pato, MT, Craddock, N, Landen, M, Smoller, JW and Sklar, P (2017) Evidence for genetic heterogeneity between clinical subtypes of bipolar disorder. Translational Psychiatry 7, e993.10.1038/tp.2016.242
Choi, J, Baek, JH, Noh, J, Kim, JS, Choi, JS, Ha, K, Kwon, JS and Hong, KS (2011) Association of seasonality and premenstrual symptoms in bipolar I and bipolar II disorders. Journal of Affective Disorders 129, 313316.10.1016/j.jad.2010.07.030
Coryell, W, Winokur, G, Shea, T, Maser, JD, Endicott, J and Akiskal, HS (1994) The long-term stability of depressive subtypes. American Journal of Psychiatry 151, 199204.
Dell'Osso, B, Camuri, G, Cremaschi, L, Dobrea, C, Buoli, M, Ketter, TA and Altamura, AC (2017) Lifetime presence of psychotic symptoms in bipolar disorder is associated with less favorable socio-demographic and certain clinical features. Comprehensive Psychiatry 76, 169176.10.1016/j.comppsych.2017.04.005
Endicott, J, Nee, J, Andreasen, N, Clayton, P, Keller, M and Coryell, W (1985) Bipolar II. Combine or keep separate? Journal of Affective Disorders 8, 1728.10.1016/0165-0327(85)90068-0
Faraone, SV, Su, J and Tsuang, MT (2004) A genome-wide scan of symptom dimensions in bipolar disorder pedigrees of adult probands. Journal of Affective Disorders 82(suppl. 1), S71S78.10.1016/j.jad.2004.05.015
Feng, LY, Yu, WJ, Chang, WT, Han, E, Chung, H and Li, JH (2016) Comparison of illegal drug use pattern in Taiwan and Korea from 2006 to 2014. Substance Abuse Treatment, Prevention, and Policy 11, 34.10.1186/s13011-016-0078-x
Geoffroy, PA, Hoertel, N, Etain, B, Bellivier, F, Delorme, R, Limosin, F and Peyre, H (2018) Insomnia and hypersomnia in major depressive episode: prevalence, sociodemographic characteristics and psychiatric comorbidity in a population-based study. Journal of Affective Disorders 226, 132141.10.1016/j.jad.2017.09.032
Gershon, ES, Hamovit, J, Guroff, JJ, Dibble, E, Leckman, JF, Sceery, W, Targum, SD, Nurnberger, JI Jr, Goldin, LR and Bunney, WE Jr (1982) A family study of schizoaffective, bipolar I, bipolar II, unipolar, and normal control probands. Archives of General Psychiatry 39, 11571167.10.1001/archpsyc.1982.04290100031006
Greenwood, TA, Bipolar Genome Study C and Kelsoe, JR (2013) Genome-wide association study of irritable vs. elated mania suggests genetic differences between clinical subtypes of bipolar disorder. PLoS ONE 8, e53804.10.1371/journal.pone.0053804
Hamshere, ML, Gordon-Smith, K, Forty, L, Jones, L, Caesar, S, Fraser, C, Hyde, S, Tredget, J, Kirov, G, Jones, I, Craddock, N and Smith, DJ (2009) Age-at-onset in bipolar-I disorder: mixture analysis of 1369 cases identifies three distinct clinical sub-groups. Journal of Affective Disorders 116, 2329.10.1016/j.jad.2008.10.021
Han, O, Ahn, S, Siong, M, Cho, J, Kim, J, Bae, S, Cho, B, Jeon, D, Suh, B, Hahm, D, Lee, J and Park, J (2000) Development of Korean version of structured clinical interview schedule for DSM-IV axis I disorder: interrater reliability. Journal of Korean Neuropsychiatric Association 39, 362372.
Hanwella, R and de Silva, VA (2011) Signs and symptoms of acute mania: a factor analysis. BMC Psychiatry 11, 137.10.1186/1471-244X-11-137
Hoertel, N, Le Strat, Y, Angst, J and Dubertret, C (2013) Subthreshold bipolar disorder in a U.S. national representative sample: prevalence, correlates and perspectives for psychiatric nosography. Journal of Affective Disorders 146, 338347.10.1016/j.jad.2012.09.016
Hong, JW, Noh, JH and Kim, DJ (2017) The prevalence of and factors associated with high-risk alcohol consumption in Korean adults: the 2009–2011 Korea National Health and Nutrition Examination Survey. PLoS ONE 12, e0175299.10.1371/journal.pone.0175299
Insel, T, Cuthbert, B, Garvey, M, Heinssen, R, Pine, DS, Quinn, K, Sanislow, C and Wang, P (2010) Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. American Journal of Psychiatry 167, 748751.10.1176/appi.ajp.2010.09091379
Joo, EJ, Joo, YH, Hong, JP, Hwang, S, Maeng, SJ, Han, JH, Yang, BH, Lee, YS and Kim, YS (2004) Korean version of the diagnostic interview for genetic studies: validity and reliability. Comprehensive Psychiatry 45, 225229.10.1016/j.comppsych.2004.02.007
Judd, LL, Akiskal, HS, Schettler, PJ, Coryell, W, Maser, J, Rice, JA, Solomon, DA and Keller, MB (2003 a) The comparative clinical phenotype and long term longitudinal episode course of bipolar I and II: a clinical spectrum or distinct disorders? Journal of Affective Disorders 73, 1932.10.1016/S0165-0327(02)00324-5
Judd, LL, Schettler, PJ, Akiskal, HS, Maser, J, Coryell, W, Solomon, D, Endicott, J and Keller, M (2003 b) Long-term symptomatic status of bipolar I vs. bipolar II disorders. International Journal of Neuropsychopharmacology 6, 127137.10.1017/S1461145703003341
Keck, PE Jr, McElroy, SL, Havens, JR, Altshuler, LL, Nolen, WA, Frye, MA, Suppes, T, Denicoff, KD, Kupka, R, Leverich, GS, Rush, AJ and Post, RM (2003) Psychosis in bipolar disorder: phenomenology and impact on morbidity and course of illness. Comprehensive Psychiatry 44, 263269.10.1016/S0010-440X(03)00089-0
Kerner, B, Lambert, CG and Muthen, BO (2011) Genome-wide association study in bipolar patients stratified by co-morbidity. PLoS ONE 6, e28477.10.1371/journal.pone.0028477
Kessler, RC, Ormel, J, Petukhova, M, McLaughlin, KA, Green, JG, Russo, LJ, Stein, DJ, Zaslavsky, AM, Aguilar-Gaxiola, S, Alonso, J, Andrade, L, Benjet, C, de Girolamo, G, de Graaf, R, Demyttenaere, K, Fayyad, J, Haro, JM, Hu, C, Karam, A, Lee, S, Lepine, JP, Matchsinger, H, Mihaescu-Pintia, C, Posada-Villa, J, Sagar, R and Ustun, TB (2011) Development of lifetime comorbidity in the World Health Organization world mental health surveys. Archives of General Psychiatry 68, 90100.10.1001/archgenpsychiatry.2010.180
Kim, JS, Ha, TH, Chang, JS, Park, YS, Huh, I, Kim, J, Hong, KS, Park, T and Ha, K (2015) Seasonality and its distinct clinical correlates in bipolar II disorder. Psychiatry Research 225, 540544.10.1016/j.psychres.2014.11.051
Labbe, A, Bureau, A, Moreau, I, Roy, MA, Chagnon, Y, Maziade, M and Merette, C (2012) Symptom dimensions as alternative phenotypes to address genetic heterogeneity in schizophrenia and bipolar disorder. European Journal of Human Genetics 20, 11821188.10.1038/ejhg.2012.67
Lee, K, Oh, H, Lee, EH, Kim, JH, Kim, JH and Hong, KS (2016) Investigation of the clinical utility of the hypomania checklist 32 (HCL-32) for the screening of bipolar disorders in the non-clinical adult population. BMC Psychiatry 16, 124.10.1186/s12888-016-0831-8
Lieberman, DZ, Peele, R and Razavi, M (2008) Combinations of DSM-IV-TR criteria sets for bipolar disorders. Psychopathology 41, 3538.10.1159/000109953
Lin, PI, McInnis, MG, Potash, JB, Willour, V, MacKinnon, DF, DePaulo, JR and Zandi, PP (2006) Clinical correlates and familial aggregation of age at onset in bipolar disorder. American Journal of Psychiatry 163, 240246.10.1176/appi.ajp.163.2.240
Maciukiewicz, M, Czerski, PM, Leszczynska-Rodziewicz, A, Kapelski, P, Szczepankiewicz, A, Dmitrzak-Weglarz, M, Skibinska, M, Pawlak, J, Hauser, J and Karlowski, WM (2012) Analysis of OPCRIT results indicate the presence of a novel ‘social functioning’ domain and complex structure of other dimensions in the Wielkopolska (Poland) population. Schizophrenia Research 138, 223232.10.1016/j.schres.2012.03.032
Maciukiewicz, M, Dmitrzak-Weglarz, M, Pawlak, J, Leszczynska-Rodziewicz, A, Zaremba, D, Skibinska, M and Hauser, J (2014) Analysis of genetic association and epistasis interactions between circadian clock genes and symptom dimensions of bipolar affective disorder. Chronobiology International 31, 770778.10.3109/07420528.2014.899244
McElroy, SL, Altshuler, LL, Suppes, T, Keck, PE Jr, Frye, MA, Denicoff, KD, Nolen, WA, Kupka, RW, Leverich, GS, Rochussen, JR, Rush, AJ and Post, RM (2001) Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. American Journal of Psychiatry 158, 420426.
McElroy, SL, Crow, S, Blom, TJ, Biernacka, JM, Winham, SJ, Geske, J, Cuellar-Barboza, AB, Bobo, WV, Prieto, ML, Veldic, M, Mori, N, Seymour, LR, Bond, DJ and Frye, MA (2016) Prevalence and correlates of DSM-5 eating disorders in patients with bipolar disorder. Journal of Affective Disorders 191, 216221.
McGrath, JA, Avramopoulos, D, Lasseter, VK, Wolyniec, PS, Fallin, MD, Liang, KY, Nestadt, G, Thornquist, MH, Luke, JR, Chen, PL, Valle, D and Pulver, AE (2009) Familiality of novel factorial dimensions of schizophrenia. Archives of General Psychiatry 66, 591600.
Meier, S, Mattheisen, M, Vassos, E, Strohmaier, J, Treutlein, J, Josef, F, Breuer, R, Degenhardt, F, Muhleisen, TW, Muller-Myhsok, B, Steffens, M, Schmael, C, McMahon, FJ, Bipolar Disorder Genome Study C, Nothen, MM, Cichon, S, Schulze, TG, Rietschel, M, Kelsoe, JR, Greenwood, TA, Nievergelt, CM, Barrett, TB, McKinney, R, Shilling, PD, Schork, NJ, Smith, EN, Bloss, CS, Nurnberger, J, Edenberg, HJ, Foroud, T, Koller, DL, Gershon, ES, Liu, CY, Badner, JA, Scheftner, W, Lawson, WB, Nwulia, EA, Hipolito, M, Coryell, W, Rice, J, Byerley, W, McMahon, F, Chen, DT, Schulze, TG, Berrettini, W, Potash, JB, Zandi, PP, Mahon, PB, McInnis, M, Craig, D and Szelinger, S (2012) Genome-wide significant association between a ‘negative mood delusions’ dimension in bipolar disorder and genetic variation on chromosome 3q26.1. Translational Psychiatry 2, e165.
Merikangas, KR, Cui, L, Heaton, L, Nakamura, E, Roca, C, Ding, J, Qin, H, Guo, W, Shugart, YY, Zarate, C and Angst, J (2014) Independence of familial transmission of mania and depression: results of the NIMH family study of affective spectrum disorders. Molecular Psychiatry 19, 214219.
Monahan, PO, Stump, T, Coryell, WH, Harezlak, J, Marcoulides, GA, Liu, H, Steeger, CM, Mitchell, PB, Wilcox, HC, Hulvershorn, LA, Glowinski, AL, Bipolar Disorder Genome Study C, Iyer-Eimerbrink, PA, McInnis, M and Nurnberger, JI (2015) Confirmatory test of two factors and four subtypes of bipolar disorder based on lifetime psychiatric co-morbidity. Psychological Medicine 45, 21812196.
Nierenberg, AA, Miyahara, S, Spencer, T, Wisniewski, SR, Otto, MW, Simon, N, Pollack, MH, Ostacher, MJ, Yan, L, Siegel, R, Sachs, GS and Investigators, S-B (2005) Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: data from the first 1000 STEP-BD participants. Biological Psychiatry 57, 14671473.
Oquendo, MA, Barrera, A, Ellis, SP, Li, S, Burke, AK, Grunebaum, M, Endicott, J and Mann, JJ (2004) Instability of symptoms in recurrent major depression: a prospective study. American Journal of Psychiatry 161, 255261.
Ostacher, MJ, Suppes, T, Swann, AC, Eudicone, JM, Landsberg, W, Baker, RA and Carlson, BX (2015) Patterns of response to aripiprazole, lithium, haloperidol, and placebo across factor scores of mania. International Journal of Bipolar Disorders 3, 11.
Ostergaard, SD, Bertelsen, A, Nielsen, J, Mors, O and Petrides, G (2013) The association between psychotic mania, psychotic depression and mixed affective episodes among 14529 patients with bipolar disorder. Journal of Affective Disorders 147, 4450.
Perlis, RH, Miyahara, S, Marangell, LB, Wisniewski, SR, Ostacher, M, DelBello, MP, Bowden, CL, Sachs, GS, Nierenberg, AA and Investigators, S-B (2004) Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biological Psychiatry 55, 875881.
Perlis, RH, Ostacher, MJ, Uher, R, Nierenberg, AA, Casamassima, F, Kansky, C, Calabrese, JR, Thase, M and Sachs, GS (2009) Stability of symptoms across major depressive episodes in bipolar disorder. Bipolar Disorder 11, 867875.
Persons, JE, Coryell, WH, Solomon, DA, Keller, MB, Endicott, J and Fiedorowicz, JG (2018) Mixed state and suicide: is the effect of mixed state on suicidal behavior more than the sum of its parts? Bipolar Disorder 20, 3541.
Rosenthal, N, Bradt, G and Wehr, T (1987) Seasonal Pattern Assessment Questionnaire. Washington, DC: National Institute of Mental Health.
Ruderfer, DM, Fanous, AH, Ripke, S, McQuillin, A, Amdur, RL, Schizophrenia Working Group of Psychiatric Genomics C, Bipolar Disorder Working Group of Psychiatric Genomics C, Cross-Disorder Working Group of Psychiatric Genomics C, Gejman, PV, O'Donovan, MC, Andreassen, OA, Djurovic, S, Hultman, CM, Kelsoe, JR, Jamain, S, Landen, M, Leboyer, M, Nimgaonkar, V, Nurnberger, J, Smoller, JW, Craddock, N, Corvin, A, Sullivan, PF, Holmans, P, Sklar, P and Kendler, KS (2014) Polygenic dissection of diagnosis and clinical dimensions of bipolar disorder and schizophrenia. Molecular Psychiatry 19, 10171024.
Sargant, W (1962) The treatment of anxiety states and atypical depressions by the monoamine oxidase inhibitor drugs. Journal of Neuropsychiatry 3(suppl. 1), S96103.
Sato, T, Bottlender, R, Kleindienst, N and Moller, HJ (2002) Syndromes and phenomenological subtypes underlying acute mania: a factor analytic study of 576 manic patients. American Journal of Psychiatry 159, 968974.
Serretti, A, Lattuada, E, Cusin, C, Macciardi, F and Smeraldi, E (1998) Analysis of depressive symptomatology in mood disorders. Depression and Anxiety 8, 8085.
Simon, NM, Otto, MW, Weiss, RD, Bauer, MS, Miyahara, S, Wisniewski, SR, Thase, ME, Kogan, J, Frank, E, Nierenberg, AA, Calabrese, JR, Sachs, GS, Pollack, MH and Investigators, S-B (2004 a) Pharmacotherapy for bipolar disorder and comorbid conditions: baseline data from STEP-BD. Journal of Clinical Psychopharmacology 24, 512520.
Simon, NM, Otto, MW, Wisniewski, SR, Fossey, M, Sagduyu, K, Frank, E, Sachs, GS, Nierenberg, AA, Thase, ME and Pollack, MH (2004 b) Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). American Journal of Psychiatry 161, 22222229.
Smith, CS, Reilly, C and Midkiff, K (1989) Evaluation of three circadian rhythm questionnaires with suggestions for an improved measure of morningness. Journal of Applied Psychology 74, 728738.
Solomon, DA, Leon, AC, Coryell, WH, Endicott, J, Li, C, Fiedorowicz, JG, Boyken, L and Keller, MB (2010) Longitudinal course of bipolar I disorder: duration of mood episodes. Archives of General Psychiatry 67, 339347.
Suppes, T, Leverich, GS, Keck, PE, Nolen, WA, Denicoff, KD, Altshuler, LL, McElroy, SL, Rush, AJ, Kupka, R, Frye, MA, Bickel, M and Post, RM (2001) The Stanley Foundation Bipolar Treatment Outcome Network. II. Demographics and illness characteristics of the first 261 patients. Journal of Affective Disorders 67, 4559.
Swann, AC, Lafer, B, Perugi, G, Frye, MA, Bauer, M, Bahk, WM, Scott, J, Ha, K and Suppes, T (2013) Bipolar mixed states: an international society for bipolar disorders task force report of symptom structure, course of illness, and diagnosis. American Journal of Psychiatry 170, 3142.
Valiengo, LL, Soeiro-de-Souza, MG, Marques, AH, Moreno, DH, Juruena, MF, Andreazza, AC, Gattaz, WF and Machado-Vieira, R (2012) Plasma cortisol in first episode drug-naive mania: differential levels in euphoric versus irritable mood. Journal of Affective Disorders 138, 149152.
Ventura, J, Nuechterlein, KH, Subotnik, KL, Gutkind, D and Gilbert, EA (2000) Symptom dimensions in recent-onset schizophrenia and mania: a principal components analysis of the 24-item Brief Psychiatric Rating Scale. Psychiatry Research 97, 129135.
Yoon, J, Shin, S, Kook, S and Lee, H (1997) A preliminary study on the Korean translation of composite scale to measure morningness-eveningness. Journal of Korean Neuropsychiatric Association 36, 122133.

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