Evidence map›Paper›PMID 29747137›Full record

ArticleJournal of affective disorders2018

Mood instability as a predictor of clinical and functional outcomes in adolescents with bipolar I and bipolar II disorder.

Lisa A O'Donnell, Alissa J Ellis, Margaret M Van de Loo, Jonathan P Stange, David A Axelson, Robert A Kowatch, Christopher D Schneck, David J Miklowitz

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of affective disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
3.9field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Mood Instability in Youth at High Risk for Bipolar Disorder.Journal of the American Academy of Child and Adolescent Psychiatry · 2022
    Trial
  4. Treatment Experiences of Individuals With Co-Occurring Mental Health and Substance Use Disorders and Perspectives of Mental Health Workers in Ashanti Region, Ghana.Health expectations : an international journal of public participation in health care and health policy · 2026
    Article
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  15. Parent and adolescent emotional variability and adolescent psychopathology.Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43) · 2023
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Lisa A O'DonnellSchool of Social Work, Wayne State University, Detroit, MI, USA. Electronic address: lisa.odonnell@wayne.edu.
Alissa J EllisSemel Institute, University of California, Los Angeles, CA, USA.
Margaret M Van de LooSemel Institute, University of California, Los Angeles, CA, USA.
Jonathan P StangeDepartment of Psychiatry, University of Illinois, Chicago, IL, USA.
David A AxelsonThe Ohio State University College of Medicine, Columbus, OH, USA.
Robert A KowatchThe Ohio State University College of Medicine, Columbus, OH, USA.
Christopher D SchneckSchool of Medicine, University of Colorado, Aurora, CO, USA.
David J MiklowitzSemel Institute, University of California, Los Angeles, CA, USA.
University of California, Los Angeles · USThe Ohio State University · USUniversity of Colorado Anschutz Medical Campus · USUniversity of Illinois Chicago · USWayne State University · US

Funding

1/2-Early Intervention for Youth at Risk for Bipolar DisorderR01MH093676 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI MIKLOWITZ, DAVID JAY · 2012 to 2016
$3.6M
Family-Focused Treatment for Bipolar AdolescentsR01MH073817 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI AXELSON, DAVID A · 2006 to 2010
$1.7M
Family-Focused Treatment for Bipolar AdolescentsR01MH073871 · NIMH · UNIVERSITY OF COLORADO · PI MIKLOWITZ, DAVID JAY · 2006 to 2010
$1.7M
Family-Focused Treatment for Bipolar AdolescentsR01MH074033 · NIMH · CINCINNATI CHILDRENS HOSP MED CTR · PI KOWATCH, ROBERT ANTHONY · 2006 to 2010
$1.3M
From Networks to the Real World: Integrating Neural and Autonomic Processes of LossK23MH112769 · NIMH · UNIVERSITY OF SOUTHERN CALIFORNIA · PI STANGE, JONATHAN P · 2017 to 2021
$931k
Family-Focused Therapy as Early Treatment for Youth at Risk for Bipolar DisorderR34MH077856 · NIMH · UNIVERSITY OF COLORADO · PI MIKLOWITZ, DAVID JAY · 2007 to 2009
$638k
Family-Focused Treatment for Youth with Early-Onset Bipolar or Psychotic DisorderR21MH097007 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI MIKLOWITZ, DAVID JAY · 2012 to 2013
$439k
NIMH NIH HHS K23 MH112769NIMH NIH HHS R01 MH073817NIMH NIH HHS R01 MH073871NIMH NIH HHS R01 MH074033NIMH NIH HHS R01 MH093676NIMH NIH HHS R21 MH097007NIMH NIH HHS R34 MH077856
6 · The paper itself

Abstract

backgroundTraditional assessment and treatment of bipolar disorder (BD) often overlooks an important feature of the illness, mood instability (MI). MI - the presence of intense, rapidly shifting emotional states - is associated with a number of poor prognostic outcomes. This study examined whether MI among adolescents with BD was cross-sectionally related to bipolar subtype (I vs. II) and prognostically associated with symptoms and functioning over 3 months.

methodsParticipants included 145 adolescents (mean age: 15.6 years ± 1.4) with BD I or II with a mood episode in the previous 3 months. Depression and (hypo)mania instability were computed using the root mean square successive difference (rMSSD) score, reflecting both the size and temporal order of changes in weekly depression and (hypo)mania scores (over 12 weeks) from the Adolescent Longitudinal Interval Follow-Up Evaluation.

resultsGreater depression instability was associated with BD II, whereas greater (hypo)mania instability was associated with BD I. Baseline MI, particularly depression, predicted more instability, a higher percentage of weeks in a clinical mood state, and poorer global functioning over 3 months, even when covarying concurrent mood severity scores. LIMITATIONS: The clinical measure of symptoms used retrospective reports of clinically significant symptoms only. We were unable to standardize medication use or adherence.

conclusionsMI differs by diagnostic subtype, is relatively stable over time, and predicts clinical and functional outcomes. Targeting MI should be considered a clinical focus to augment traditional methods of assessing and treating BD during adolescence to enhance clinical and functional outcomes.

Indexed as

AffectAdolescentBipolar DisorderDepressionEmotionsFemaleHumansMalePatient Outcome AssessmentRegression AnalysisRetrospective StudiesAdolescenceAffective instabilityChildhood-onset bipolar disorderMood disordersPsychosocial functioning

Identifiers

PMID29747137
PMCPMC5997484
OpenAlexW2796348203

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.