EPA-1181 – Mood instability explains the relationship between impulsivity and depression

Background: Impulsivity may be an important risk factor in terms of future self-harm. However, the extent of this, whether it may relate to self-harm that is new in onset and/or repetition of self-harm, and the detail of any interaction with mood instability (MI) and childhood sexual abuse (CSA) requires detailed examination. Aims: We used the 2000 Adult Psychiatry Morbidity Survey and an 18-month follow-up data to test hypotheses relating to the role of impulsivity, CSA and MI in the inception and persistence of self-harm. Methods: We assessed associations of impulsivity with (1) suicidal self-harm (SSH) and (2) non-SSH (NSSH) at baseline and follow-up, controlling for confounders including MI. Finally, we tested whether impulsivity mediated the relationship between CSA and self-harm. Results: A total of 8,580 respondents were assessed at baseline and 2,406 at follow-up as planned. Impulsivity significantly predicted emergence of new NSSH at 18-month follow-up even after adjustment for MI and other confounders. Impulsivity did not significantly predict repetition of NSSH, or repetition or new inception of SSH, even before inclusion of MI in the model. However, the absolute numbers involved were small. Cross-sectionally, impulsivity was a stronger mediator of the link between CSA and SSH (13.1%) than that between CSA and NSSH (4.8%). Conclusion: Impulsivity may increase the risk of future development of NSSH independently of MI, which is clinically important for risk assessment. The involvement of impulsivity in the repetition of self-harm generally appears less certain. However, impulsivity may have a role in SSH in the context of previous CSA.

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Mood instability, depression, and anxiety in pregnancy and adverse neonatal outcomes

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04021-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hua Li ◽

Angela Bowen ◽

Rudy Bowen ◽

Nazeem Muhajarine ◽

Lloyd Balbuena

Keyword(s):

Depression Scale ◽

Late Pregnancy ◽

Neonatal Outcomes ◽

Depression And Anxiety ◽

Logistic Regression Models ◽

Mood Instability ◽

Antenatal Depressive Symptoms ◽

Adverse Neonatal Outcomes ◽

The Relationship ◽

In Pregnancy

Abstract Background Antenatal women experience an increased level of mood and anxiety symptoms, which have negative effects on mothers’ mental and physical health as well as the health of their newborns. The relation of maternal depression and anxiety in pregnancy with neonate outcomes is well-studied with inconsistent findings. However, the association between antenatal mood instability (MI) and neonatal outcomes has not been investigated even though antenatal women experience an elevated level of MI. We sought to address this gap and to contribute to the literature about pregnancy neonate outcomes by examining the relationship among antenatal MI, depression, and anxiety and neonatal outcomes. Methods A prospective cohort of women (n = 555) participated in this study at early pregnancy (T1, 17.4 ± 4.9 weeks) and late pregnancy (T2, 30.6 ± 2.7 weeks). The Edinburgh Postnatal Depression Scale (EPDS) was used to assess antenatal depressive symptoms, anxiety was measured by the EPDS anxiety subscale, and mood instability was measured by a visual analogue scale with five questions. These mood states together with stress, social support, as well as lifestyle were also examined in relation to neonatal outcomes using chi-square tests and logistic regression models. Results Mood instability, depression, and anxiety were unrelated to adverse neonatal outcomes. Only primiparous status was associated with small for gestational age after Bonferroni correction. Conclusions We report no associations between antenatal mood symptoms including MI, depression, and anxiety and neonatal outcomes. More studies are required to further explore the relationship between antenatal mood instability, depression, and anxiety and neonatal outcomes.

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The relationship between mood instability and depression: Implications for studying and treating depression

Medical Hypotheses ◽

10.1016/j.mehy.2013.06.010 ◽

2013 ◽

Vol 81 (3) ◽

pp. 459-462 ◽

Cited By ~ 15

Author(s):

R.C. Bowen ◽

Y. Wang ◽

L. Balbuena ◽

A. Houmphan ◽

M. Baetz

Keyword(s):

Mood Instability ◽

The Relationship

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The Relationship Between ADHD Symptoms, Mood Instability, and Self-Reported Offending

Journal of Attention Disorders ◽

10.1177/1087054711429791 ◽

2012 ◽

Vol 17 (4) ◽

pp. 339-346 ◽

Cited By ~ 22

Author(s):

Gisli H. Gudjonsson ◽

Jon Fridrik Sigurdsson ◽

Tomas F. Adalsteinsson ◽

Susan Young

Keyword(s):

Adhd Symptoms ◽

Mood Instability ◽

The Relationship

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Characterization of Mood Instability through Bipolar Disorders: A cluster-analytic approach using weekly prospective life-chart methodology

European Psychiatry ◽

10.1016/j.eurpsy.2018.10.003 ◽

2019 ◽

Vol 57 ◽

pp. 52-57 ◽

Cited By ~ 2

Author(s):

A.G. Szmulewicz ◽

D.J. Martino ◽

S.A. Strejilevich

Keyword(s):

Bipolar Disorders ◽

Hierarchical Cluster ◽

Type I ◽

Type Ii ◽

Mood Instability ◽

Cluster Analytic ◽

Subsyndromal Symptoms ◽

The Relationship

AbstractBackgroundThe aim of this study was to characterize mood instability (MI) in Bipolar Disorder (BD) and to investigate potential differences between subtype I and II.MethodsLife-charts from weekly mood ratings of 90 patients were used to compute: weeks spent with symptoms, number of episodes, and MI. Regression analyses were conducted to assess the relationship between BD subtype and MI adjusting by all potential confounding factors. Hierarchical cluster analysis was performed to determine the appropriate number of clusters that described the data and to assign subjects to a specific cluster based on their MI. We then compared clusters on clinical and psychosocial outcomes.ResultsMedian follow-up was 5 years (IQR: 3.6–7.9). Patients spent 15.2%, 5%, and 3% of follow-up with depressive, manic, and mixed symptoms, respectively. BD type II presented higher MI (β = 1.83, 95% CI: 0.66–3.00) and subsydromal symptoms than BD type I patients. No differences in functioning or recurrences were found between subtypes. Differences in MI between the two clusters mimicked those between type I and II but enhanced (β = 3.86, 95%CI -4.72, -2.66). High MI (n = 43) patients presented poorer functioning and higher recurrences compared to Low MI patients (n = 43).ConclusionBD type II presented higher MI and subsyndromal symptoms than BD type I patients. However, these differences did not translate into clinically relevant outcomes. A classification based on MI may provide useful clinical insights.

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The relationship of mood instability to neuroticism and suicidal thoughts

European Psychiatry ◽

10.1016/s0924-9338(11)72716-x ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1011-1011

Author(s):

R. Bowen ◽

M. Baetz

Keyword(s):

Diagnostic Interview ◽

Depression Symptoms ◽

Suicidal Thoughts ◽

Mood Instability ◽

Broad Concept ◽

Instability Factor ◽

Neuroticism Scale ◽

Affective Lability ◽

Relationship Of ◽

The Relationship

IntroductionMany patients with depression mention sudden short “mood swings” (MI) when asked. MI is distressing but little is known about its relationship to personality disorders, depression and suicidal thoughts.ObjectivesTo determine the relationship between mood instability (MI), neuroticism, and suicidal thoughts.AimsTo deconstruct the concept of neuroticism to determine whether MI is an important component. To determine whether MI predicts suicidal thoughts.Methods129 patients with Major Depression were interviewed with the MINI diagnostic interview. They also completed the Eysenck Neuroticism Scale (ENS), Beck Depression Inventory (BDI), Mood Disorders Questionnaire (MDQ), Perceived Stress Scale (PSS), Affective Lability Scale (ALS), Beck Suicide Scale (BSS) and 5 questions describing mood swings and its effects on behaviour.ResultsIn a regression analysis with the BSS as the dependent variable, with age and sex controlled, and all of the other variables entered, only the BDI (p < 0.001) and the ALS (p < 0.01) were significant predictors. In an exploratory factor analysis of the ENS, 3 main factors (53% of variance) emerged. 2 of the factors consisted of mild anxiety and depression symptoms. The third factor (16% variance) was a mood instability factor. The ALS and the ENS both correlated with the 5 questions describing mood swings, but the correlations with the ALS were stronger.ConclusionsMood Instability is the unique component of neuroticism. MI (ALS) predicts suicidal thoughts along with the broad concept of depression (BDI). In this model, neuroticism (ENS) is not a predictor.

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