Does Screening for Bipolar Disorders Identify a “Dysregulation of Mood, Energy, and Social Rhythms Syndrome” (DYMERS)? A Heuristic Working Hypothesis
Abstract
:1. Introduction
- (1)
- Can the impairment be found to be associated with a positive score on the MDQ and, specifically, the impairment of quality of life, which is evidently not attributable to the presence of a bipolar disorder (given the high frequency of “false positives”), be attributed to the concomitance of associated disorders, or is it an “intrinsic” characteristic of people scoring positive on the MDQ?
- (2)
- If the impairment was not specifically associated with positivity with other disorders, would it be possible to think that a positive score on the MDQ (and the associated rhythm dysregulation) could be a stress factor constituting a trigger for many disorders and, therefore, a co-factor that triggers the eventual genetic disposition?
2. Materials and Methods
2.1. Design
2.2. Recruitment Methods and Study Sample
2.3. Study Tools
2.4. Ethics
2.5. Statistical Analysis
3. Results
4. Discussion
- (1)
- Episodic increase in adaptive energy (typical, for example, of the sports stars that perform excellently even if they do not sleep the day before the race due to the hyper-activation [84]), which a previous study identified in healthy and well-adapted hyperactive elderly people who possessed one of the genetic variants also found to be associated with bipolar disorder [64,65,66].
- (2)
- Episodic increase in energy that enters the stress area and is associated with the dysregulation of social rhythms (sleep, eating, and relational). This condition is typical of MDQ positivity and is associated with anxiety disorders and post-traumatic stress disorder (more closely than bipolar disorder), but not exclusively, as it is even found alone in MDQ positives without co-morbidity. The increase in energy is still finalized, but inefficacy in resolving issues (hence short-circuiting the stress as, for example, seen paradoxically in some cases of burnout/occupational stress syndromes [85]) may impair the health-related quality of life.
- (3)
- Hypomania with mood dysregulation and bipolar disorder implies a strong out-of-control hyperactivation that loses relationships with adaptive goals and often rebounds into depression. In this case, the increase in energy is such that it can be clinically identified as a hypomanic episode. This condition does not only require greater stress and environmental factors but also, possibly, a specific and additional genetic risk component. In fact, it has been shown that genetic risk and a positive score on the MDQ could be independent components of BD [67]. A predisposition to hyperactivity could be the substrate of the disorder if activated by great stress.
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Age | Sex | MDQ+ Score | MDQ− Score | Case-SF12 Score | Control- SF12 Score | Diagnosis | |
---|---|---|---|---|---|---|---|
1 | 21 | M | 9 | 0 | 45 | 45 | N (None) |
2 | 22 | F | 10 | 3 | 39 | 40 | N |
3 | 23 | M | 9 | 3 | 43 | 42 | N |
4 | 24 | F | 8 | 0 | 40 | 40 | Specific Phobia |
5 | 25 | M | 8 | 0 | 35 | 41 | N |
6 | 25 | F | 11 | 0 | 34 | 46 | N |
7 | 26 | F | 8 | 0 | 38 | 42 | Anorexia |
8 | 27 | M | 8 | 1 | 27 | 44 | N |
9 | 27 | M | 8 | 0 | 40 | 42 | N |
10 | 28 | F | 11 | 1 | 24 | 42 | N |
11 | 29 | F | 9 | 3 | 27 | 36 | Obsessive-compulsive disorder (OCD) |
12 | 30 | M | 8 | 5 | 45 | 43 | N |
13 | 31 | M | 13 | 0 | 23 | 43 | N |
14 | 32 | F | 8 | 1 | 39 | 38 | N |
15 | 33 | M | 8 | 0 | 37 | 44 | N |
16 | 35 | M | 14 | 0 | 38 | 45 | N |
17 | 36 | M | 13 | 1 | 34 | 38 | N |
18 | 38 | F | 10 | 0 | 43 | 44 | N |
19 | 41 | F | 12 | 0 | 35 | 41 | N |
20 | 42 | F | 10 | 0 | 40 | 42 | N |
21 | 43 | M | 10 | 5 | 29 | 43 | N |
22 | 45 | M | 11 | 0 | 29 | 44 | N |
23 | 49 | M | 8 | 1 | 42 | 46 | N |
24 | 49 | F | 10 | 0 | 33 | 42 | N |
25 | 50 | M | 10 | 0 | 25 | 46 | N |
26 | 50 | M | 8 | 0 | 47 | 44 | N |
27 | 50 | F | 11 | 1 | 39 | 34 | N |
28 | 52 | F | 8 | 0 | 36 | 44 | N |
29 | 54 | M | 8 | 0 | 42 | 41 | N |
30 | 54 | F | 8 | 1 | 36 | 44 | N |
31 | 54 | F | 9 | 4 | 31 | 32 | N |
32 | 57 | F | 13 | 5 | 40 | 43 | N |
33 | 59 | M | 11 | 0 | 23 | 33 | N |
34 | 59 | F | 8 | 0 | 35 | 41 | N |
35 | 60 | M | 9 | 0 | 33 | 39 | N |
36 | 61 | M | 10 | 0 | 33 | 39 | N |
37 | 62 | M | 8 | 0 | 31 | 38 | N |
38 | 63 | M | 8 | 1 | 32 | 46 | N |
39 | 63 | F | 9 | 0 | 29 | 42 | N |
40 | 65 | M | 8 | 0 | 43 | 43 | N |
41 (23M) | 67 | M | 9 | 1 | 30 | 39 | N |
42.95 ± 14.34 | 9.48 ± 1.68 | 0.90 ± 1.51 | 35.21 ± 6.30 | 41.48 ± 3.39 | F(1,81DF) = 31.492 p < 0.0001 | ||
≥50 N = 17 | 57.64 ± 5.34 | 34.68 ± 6.26 | 40.47 ± 4.17 | F(1,33)= 15.511 p < 0.0001 | |||
<50 N = 24 | 32.54 ± 8.37 | 35.79 ± 6.33 | 42.20 ± 2.46 | F(1,47) = 21.828 p < 0.0001 |
MDQ+ | MDQ− | Chi-Square | p | OR (CI 95%) | |
---|---|---|---|---|---|
People with SF-12 score ≤ 35 | 19 | 3 | 15.903 | <0.0001 | 10.93 (2.90–41.19) |
People with SF-12 score > 35 | 22 | 38 | |||
People with SF-12 score ≤ 35 (Only ≥50) | 9 | 3 | 4.636 | 0.031 | 5.25 (1.09–25.21) |
People with SF-12 score > 35 (Only ≥50) | 8 | 14 | |||
People with SF-12 score ≤ 35 (Only <50) | 10 | 0 | 11.007 | <0.0001 | Inf (NC) |
People with SF-12 score > 35 (Only <50) | 14 | 24 |
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Carta, M.G.; Kalcev, G.; Fornaro, M.; Pinna, S.; Gonzalez, C.I.A.; Nardi, A.E.; Primavera, D. Does Screening for Bipolar Disorders Identify a “Dysregulation of Mood, Energy, and Social Rhythms Syndrome” (DYMERS)? A Heuristic Working Hypothesis. J. Clin. Med. 2023, 12, 5162. https://doi.org/10.3390/jcm12155162
Carta MG, Kalcev G, Fornaro M, Pinna S, Gonzalez CIA, Nardi AE, Primavera D. Does Screening for Bipolar Disorders Identify a “Dysregulation of Mood, Energy, and Social Rhythms Syndrome” (DYMERS)? A Heuristic Working Hypothesis. Journal of Clinical Medicine. 2023; 12(15):5162. https://doi.org/10.3390/jcm12155162
Chicago/Turabian StyleCarta, Mauro Giovanni, Goce Kalcev, Michele Fornaro, Samantha Pinna, Cesar Ivan Aviles Gonzalez, Antonio Egidio Nardi, and Diego Primavera. 2023. "Does Screening for Bipolar Disorders Identify a “Dysregulation of Mood, Energy, and Social Rhythms Syndrome” (DYMERS)? A Heuristic Working Hypothesis" Journal of Clinical Medicine 12, no. 15: 5162. https://doi.org/10.3390/jcm12155162