A Critical Evaluation of Dynamical Systems Models of Bipolar Disorder

Bipolar disorder (BD) is a mood disorder involving recurring (hypo)manic and depressive episodes. The inherently temporal nature of BD has inspired its conceptualization using dynamical systems theory, which is a mathematical framework for understanding systems that evolve over time. In this paper we provide a critical review of dynamical systems models of BD. Owing to heterogeneity of methodologies and experimental designs in computational modeling, we designed a structured approach to guide our review in a fashion that parallels the appraisal of animal models by their Face, Predictive, and Construct Validity. This tool, the Validity Appraisal Guide for Computational Models (VAG-CM) is not an absolute estimate of validity, but rather a guide for more objective appraisal of models in this review. We identified 26 studies published before November 18, 2021 that proposed generative dynamical systems models of time-varying signals in BD. Two raters independently applied the VAG-CM to included studies, obtaining a mean Cohen's kappa of 0.55 (95% CI [0.45, 0.64]) prior to establishing consensus ratings. Consensus VAG-CM ratings revealed three model/study clusters: data-driven models with face validity, theory-driven models with predictive validity, and theory-driven models lacking all forms of validity. We conclude that future models should be developed using a hybrid approach that first operationalizes BD features of interest using empirical data (a data-driven approach), followed by explanations of those features using generative models with components that are homologous to physiological or psychological systems involved in BD (a theory-driven approach).