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This trial has two studies. In study 1, the investigators will explore the relationships between three psychobiological factors (sleep patterns, motor activity, and decision-making ability). The investigators aim to investigate how these factors interact in BD patients. This understanding will facilitate the distinction of BD patients from patients with recurrent depressive disorder (MDD) and healthy controls.
In study 2, the investigators will continue following patients with bipolar disorder and use the interplay between the three psychobiological factors to develop early markers of full-blown affective episodes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bipolar Patients | 150 Individuals with a diagnosis of bipolar disorder will participate in studies 1 and 2 | ||
| New Mood Disorder Patients | 250 patients from three affective clinics in the Stockholm Region (Northwest Psychiatry, North Stockholm Psychiatry, Southwest Psychiatry) who have been referred for assessment for bipolar disorder. Based on clinical experience, approximately 20% (approximately 50 patients) will ultimately be diagnosed with bipolar disorder, while the remaining 200 patients will retain their diagnosis of recurrent depression and be included as a comparison group in study 1 only. The 50 patients newly diagnosed with bipolar disorder will be included in studies 1 and 2. | ||
| Healthy control | 200 Individuals with no major psychiatric disorder will participate in study 1 only. |
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| Measure | Description | Time Frame |
|---|---|---|
| Sleep onset | Smartwatch measure of sleep onset. | 12 weeks for study 1; 1 year for study 2 |
| Motor activity | Smartwatch data on number of steps each half time of the day | 12 weeks for study 1; 1 year for study 2 |
| Learning rate | We will administer a reward learning task and use computational modeling to extract a learning rate. | 12 weeks for study 1; 1 year for study 2 |
| Reward sensitivity | We will administer a valence go/no go task and use computational model to extract reward sensitivity. | 12 weeks for study 1; 1 year for study 2 |
| Motivational bias | We will administer a valence go/no go task and use computational model to extract a motivational bias. | 12 weeks for study 1; 1 year for study 2 |
| Effort discounting | We will administer an effort discounting task and use computational modeling to extract an effort discounting parameter. | 12 weeks for study 1; 1 year for study 2 |
| Foraging exit threshold | We will administer foraging task and calculate a foraging exit threshold. | 12 weeks for study 1; 1 year for study 2 |
| Sleep duration |
| Measure | Description | Time Frame |
|---|---|---|
| Questionnaire | Karolinska Sleep Questionnaire (KSQ) | 12 weeks for study 1; 1 year for study 2 |
| Questionnaire | Reduced Morningness-Eveningness Questionnaire |
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Inclusion Criteria:
For all participants:
For patients with bipolar disorder
For patients with recurrent depression
Exclusion Criteria:
Common to all participants:
For adults without psychiatric illness:
For patients with bipolar disorder and patients with recurrent depression:
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| ID | Term |
|---|---|
| D003865 | Depressive Disorder, Major |
| D019964 | Mood Disorders |
| D001714 | Bipolar Disorder |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D003866 | Depressive Disorder |
| D001523 | Mental Disorders |
| D000068105 | Bipolar and Related Disorders |
| D001519 | Behavior |
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Smartwatch measure of sleep duration. |
| 12 weeks for study 1; 1 year for study 2 |
| Sleep quality | Smartwatch measure of sleep quality. | 12 weeks for study 1; 1 year for study 2 |
| 12 weeks for study 1; 1 year for study 2 |
| Questionnaire | Center for Epidemiologic Studies Depression Scale Revised (CESD-R) | 12 weeks for study 1; 1 year for study 2 |
| Questionnaires | Altman Self-Rating Mania Scale (ASRM) | 12 weeks for study 1; 1 year for study 2 |
| Questionnaire | Munich Chronotype Questionnaire (MCTQ) | 12 weeks for study 1; 1 year for study 2 |
| Questionnaire | Insomnia Severity | 12 weeks for study 1; 1 year for study 2 |
| Questionnaire | Patient Health Questionnaire-9 (PHQ-9) | 12 weeks for study 1; 1 year for study 2 |