Date of Award

Spring 1-1-2014

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology & Neuroscience

First Advisor

David Miklowitz

Second Advisor

Sona Dimidjian

Third Advisor

Erik Willcutt

Fourth Advisor

Gregory Carey

Fifth Advisor

Roger King

Abstract

BACKGROUND: Most longitudinal research in adolescent and adult bipolar populations relies on the memory of participants recalling historical moods spanning months or even years. Asking people to recall these historical mood episodes subjects resulting data to recall biases. The current study aims to examine the feasibility and validity of a method for collecting course of illness data in real-time, from adolescents with bipolar I and II disorder using the TrueColours Self-Management System (TCSMS), a text-message and Internet-based mood monitoring system for individuals with bipolar disorder.

METHODS: A total of 18 adolescents (male = 6 , female = 12; mean age = 17) with bipolar disorder (BPI = 12, BPII = 6) and 22 (male = 12, female = 10; mean age = 15) adolescents without any mood disorder, provided mood ratings in response to weekly cell phone textmessage or email prompts (Text = 15, Email = 3) for 3 months. Participants provided weekly ratings on the Altman Self-Rating Mania Scale and the Quick Inventory of Depressive Symptoms Self-Report. Comparisons on time spent with mood symptoms were made between the bipolar and control groups.

RESULTS: Control participants were significantly more adherent to the TCSMS weekly protocol than bipolar participants. By TCSMS ratings, bipolar participants differed from controls both the average severity of depressive symptoms and in the variability of depressive symptoms over time. Bipolar subjects reported the majority of weeks with depressive symptoms; of depressed weeks, the majority were spent with mild symptoms. Bipolar and control participants did not differ on average severity of reported mania symptoms, variability of these symptoms over, or number of polarity switches. Among the bipolar participants, higher mania ratings were associated with more polarity switches over time. More time with manic symptoms predicted more time spent with mixed manic and depressive symptoms.

CONCLUSIONS: The TCSMS may be a reliable alternative to clinician-gathered, retrospective data in the longitudinal course of adolescent bipolar disorder. However, the study is limited by shorter follow-up duration, that may not have allowed sufficient time for manic symptoms to present themselves, resulting in lack of differentiation between bipolar and control participants

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