Heidi Ka Ying Lo, Roger S McIntyre, Iris Wai Tung Tsui, Fiona Yan Yee Ho, Ting Kin Ng, Corine Sau Man Wong, Suet Ying Yuen, Chit Tat Lee, Chun Yin Poon, Inez Myin-Germeys, Ka Fai Chung
{"title":"重度抑郁发作期间积极情绪、快感缺乏和生活意义的双向关联：单极和双相个体及健康对照的生态瞬时评估研究","authors":"Heidi Ka Ying Lo, Roger S McIntyre, Iris Wai Tung Tsui, Fiona Yan Yee Ho, Ting Kin Ng, Corine Sau Man Wong, Suet Ying Yuen, Chit Tat Lee, Chun Yin Poon, Inez Myin-Germeys, Ka Fai Chung","doi":"10.1192/bjo.2025.10067","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Diagnostic accuracy is an unmet need for major depressive disorder (MDD) and major depressive episode (MDE) in bipolar disorder. Very limited research has evaluated bipolar disorder/MDE and MDD using ecological momentary assessment (EMA) time-series data.</p><p><strong>Aims: </strong>We aimed to examine differentiating phenomenological characteristics in positive affect dynamics, and temporal relationships with pleasure towards current activity and meaning in life (MIL), among MDD, MDE/bipolar disorder and healthy controls using EMA.</p><p><strong>Method: </strong>Participants (<i>N</i> = 88, mean age 28.7 years, 69% female), including individuals with MDD (<i>n</i> = 29) and MDE/bipolar disorder (<i>n</i> = 29) and healthy controls (<i>n</i> = 30), were assessed for positive affect, pleasure and MIL 5 times daily over a 2-week period. Multilevel modelling analysis was conducted, with estimation of first-order autoregressive model structure and time-lagged relationship between pleasure and positive affect.</p><p><strong>Results: </strong>From 4632 EMA observations, positive affect dynamics (inertia, variability and instability) did not differ significantly across groups (all <i>P</i> > 0.05). Although all groups demonstrated a bidirectional relationship between positive affect and pleasure, for MDE/bipolar disorder, both pleasure<sub><i>t</i> - 1</sub> (<i>β</i> = -0.11, <i>t</i>[51.09] = -2.31, <i>P</i> = 0.025) and positive affect<sub><i>t</i> - 1</sub> (<i>β</i> = -0.13, <i>t</i>[56.54] = -2.30, <i>P</i> = 0.025) predicted subsequent MIL less significantly than for MDD and healthy controls.</p><p><strong>Conclusion: </strong>Individuals with MDE/bipolar disorder, but not MDD, had less self-reported MIL from positive affect and pleasure. There is little evidence that emotional experience alone characterises the pathophysiology between MDD and MDE/bipolar disorder; such investigation may be limited by within-group heterogeneity. Our findings provide a new perspective on using a time-series approach beyond bimodal measures in EMA to differentiate bipolar disorder/MDE and MDD.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 4","pages":"e141"},"PeriodicalIF":3.9000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247073/pdf/","citationCount":"0","resultStr":"{\"title\":\"Bidirectional associations among positive affect, anhedonia and meaning in life during major depressive episode: ecological momentary assessment study in unipolar and bipolar individuals and healthy controls.\",\"authors\":\"Heidi Ka Ying Lo, Roger S McIntyre, Iris Wai Tung Tsui, Fiona Yan Yee Ho, Ting Kin Ng, Corine Sau Man Wong, Suet Ying Yuen, Chit Tat Lee, Chun Yin Poon, Inez Myin-Germeys, Ka Fai Chung\",\"doi\":\"10.1192/bjo.2025.10067\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Diagnostic accuracy is an unmet need for major depressive disorder (MDD) and major depressive episode (MDE) in bipolar disorder. Very limited research has evaluated bipolar disorder/MDE and MDD using ecological momentary assessment (EMA) time-series data.</p><p><strong>Aims: </strong>We aimed to examine differentiating phenomenological characteristics in positive affect dynamics, and temporal relationships with pleasure towards current activity and meaning in life (MIL), among MDD, MDE/bipolar disorder and healthy controls using EMA.</p><p><strong>Method: </strong>Participants (<i>N</i> = 88, mean age 28.7 years, 69% female), including individuals with MDD (<i>n</i> = 29) and MDE/bipolar disorder (<i>n</i> = 29) and healthy controls (<i>n</i> = 30), were assessed for positive affect, pleasure and MIL 5 times daily over a 2-week period. Multilevel modelling analysis was conducted, with estimation of first-order autoregressive model structure and time-lagged relationship between pleasure and positive affect.</p><p><strong>Results: </strong>From 4632 EMA observations, positive affect dynamics (inertia, variability and instability) did not differ significantly across groups (all <i>P</i> > 0.05). Although all groups demonstrated a bidirectional relationship between positive affect and pleasure, for MDE/bipolar disorder, both pleasure<sub><i>t</i> - 1</sub> (<i>β</i> = -0.11, <i>t</i>[51.09] = -2.31, <i>P</i> = 0.025) and positive affect<sub><i>t</i> - 1</sub> (<i>β</i> = -0.13, <i>t</i>[56.54] = -2.30, <i>P</i> = 0.025) predicted subsequent MIL less significantly than for MDD and healthy controls.</p><p><strong>Conclusion: </strong>Individuals with MDE/bipolar disorder, but not MDD, had less self-reported MIL from positive affect and pleasure. There is little evidence that emotional experience alone characterises the pathophysiology between MDD and MDE/bipolar disorder; such investigation may be limited by within-group heterogeneity. Our findings provide a new perspective on using a time-series approach beyond bimodal measures in EMA to differentiate bipolar disorder/MDE and MDD.</p>\",\"PeriodicalId\":9038,\"journal\":{\"name\":\"BJPsych Open\",\"volume\":\"11 4\",\"pages\":\"e141\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247073/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJPsych Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1192/bjo.2025.10067\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJPsych Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1192/bjo.2025.10067","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Bidirectional associations among positive affect, anhedonia and meaning in life during major depressive episode: ecological momentary assessment study in unipolar and bipolar individuals and healthy controls.
Background: Diagnostic accuracy is an unmet need for major depressive disorder (MDD) and major depressive episode (MDE) in bipolar disorder. Very limited research has evaluated bipolar disorder/MDE and MDD using ecological momentary assessment (EMA) time-series data.
Aims: We aimed to examine differentiating phenomenological characteristics in positive affect dynamics, and temporal relationships with pleasure towards current activity and meaning in life (MIL), among MDD, MDE/bipolar disorder and healthy controls using EMA.
Method: Participants (N = 88, mean age 28.7 years, 69% female), including individuals with MDD (n = 29) and MDE/bipolar disorder (n = 29) and healthy controls (n = 30), were assessed for positive affect, pleasure and MIL 5 times daily over a 2-week period. Multilevel modelling analysis was conducted, with estimation of first-order autoregressive model structure and time-lagged relationship between pleasure and positive affect.
Results: From 4632 EMA observations, positive affect dynamics (inertia, variability and instability) did not differ significantly across groups (all P > 0.05). Although all groups demonstrated a bidirectional relationship between positive affect and pleasure, for MDE/bipolar disorder, both pleasuret - 1 (β = -0.11, t[51.09] = -2.31, P = 0.025) and positive affectt - 1 (β = -0.13, t[56.54] = -2.30, P = 0.025) predicted subsequent MIL less significantly than for MDD and healthy controls.
Conclusion: Individuals with MDE/bipolar disorder, but not MDD, had less self-reported MIL from positive affect and pleasure. There is little evidence that emotional experience alone characterises the pathophysiology between MDD and MDE/bipolar disorder; such investigation may be limited by within-group heterogeneity. Our findings provide a new perspective on using a time-series approach beyond bimodal measures in EMA to differentiate bipolar disorder/MDE and MDD.
期刊介绍：
Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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