Is smartphone-based mood instability associated with stress, quality of life and functioning in bipolar disorder?

Mood instability in patients with bipolar disorder has been associated with impaired functioning and risk of relapse. The present study aimed to investigate whether increased mood instability is associated with increased perceived stress and impaired quality of life and functioning in patients with bipolar disorder. A total of 84 patients with bipolar disorder used a smartphone-based self-monitoring system on a daily basis for nine months. Data on perceived stress, quality of life and clinically rated functioning were collected at five fixed time points for each patient during follow-up. A group of 37 healthy individuals served as a control comparison of perceived stress, quality of life and psychosocial functioning. The majority of patients presented in full or partial remission. As hypothesized, mood instability was significantly associated with increased perceived stress (B: 10.52, 95% CI: 5.25; 15.77, p