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Associations between mood instability and emotional processing in a large cohort of bipolar patients

Published online by Cambridge University Press:  30 August 2016

A. C. Bilderbeck ,
Z. E. Reed ,
H. C. McMahon ,
L. Z. Atkinson ,
J. Price ,
J. R. Geddes ,
G. M. Goodwin  and
C. J. Harmer
A. C. Bilderbeck*
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
Z. E. Reed
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, UK.
H. C. McMahon
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
L. Z. Atkinson
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
J. Price
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
J. R. Geddes
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
G. M. Goodwin
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
C. J. Harmer
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
*
*Address for correspondence: Dr A. C. Bilderbeck, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK. (Email: amy.bilderbeck@psych.ox.ac.uk)
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Abstract

Background

Aberrant emotional biases have been reported in bipolar disorder (BD), but results are inconsistent. Despite the clinical relevance of chronic mood variability in BD, there is no previous research investigating how the extent of symptom fluctuations in bipolar disorder might relate to emotional biases. This exploratory study investigated, in a large cohort of bipolar patients, whether instability in weekly mood episode symptoms and other clinical and demographic factors were related to emotional bias as measured in a simple laboratory task.

Method

Participants (N = 271, BDI = 206, BDII = 121) completed an ‘emotional categorization and memory’ task. Weekly self-reported symptoms of depression and mania were collected prospectively. In linear regression analyses, associations between cognitive bias and mood variability were explored together with the influence of demographic and clinical factors, including current medication.

Results

Greater accuracy in the classification of negative words relative to positive words was associated with greater instability in depressive symptoms. Furthermore, greater negative bias in free recall was associated with higher instability in manic symptoms. Participants diagnosed with BDII, compared with BDI, showed overall better word recognition and recall. Current antipsychotic use was associated with reduced instability in manic symptoms but this did not impact on emotional processing performance.

Conclusions

Emotional processing biases in bipolar disorder are related to instability in mood. These findings prompt further investigation into the underpinnings as well as clinical significance of mood instability.

Keywords

Bipolar disorderemotional biasemotional processingmood instabilitymood symptoms
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 15 , November 2016 , pp. 3151 - 3160
Copyright
Copyright © Cambridge University Press 2016 

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