Background Episodic changes in mood characterise disorders such as bipolar disorder, which includes distinct periods of manic excitability or irritability, along with additional symptoms experienced during these periods. Common clinical understanding informs diagnostic criteria and epidemiological studies reflect clinical thresholds. Aims To use a data-driven approach to defining groupings of symptoms experienced during periods of manic or irritable mood, which could inform understanding of mood disorders and guide case classification by identifying subgroups with homogeneous clinical/functional outcomes. Methods We used latent class analysis (LCA) to conduct an exploration of the latent structure in symptom responses in the UK Biobank and PROTECT studies, by investigating how symptoms, experienced during periods of manic or irritable mood, formed latent subgroups. We tested associations of latent subgroups with sociodemographic characteristics, diagnoses of psychiatric disorders and polygenic risk scores (PRS). Results Five latent classes were identified that captured patterns of symptoms experienced during periods of manic or irritable mood (N=42,183) in UK Biobank. We identified one class that experienced disruptive episodes of mostly irritable mood that was largely comprised of cases of depression/anxiety, and a class of individuals with increased confidence/creativity that reported lower disruptiveness and lower functional impairment. The five latent classes were replicated in an independent cohort, the PROTECT study (N=4,445), with similar distinctions between classes. Conclusion Our data-driven approach to grouping individuals identified distinct latent classes. A dimensional classification of mood disorders informed by our findings will be able to better assess or subtype these disorders in future studies.

中文翻译：

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两个基于人群的队列中躁狂或易怒发作症状的潜在亚型

背景 情绪的发作性变化是双相情感障碍等疾病的特征，包括躁狂兴奋或易怒的不同时期，以及在这些时期经历的其他症状。共同的临床理解为诊断标准提供信息，流行病学研究反映了临床阈值。目的使用数据驱动的方法来定义躁狂或烦躁情绪期间经历的症状分组，这可以通过识别具有同质临床/功能结果的亚组来了解情绪障碍并指导病例分类。方法 我们使用潜在类别分析 (LCA) 来探索英国生物银行和 PROTECT 研究中症状反应的潜在结构，通过调查躁狂或烦躁情绪期间的症状，形成了潜在的亚群。我们测试了潜在亚组与社会人口学特征、精神疾病诊断和多基因风险评分 (PRS) 的关联。结果 确定了五个潜在类别，它们捕获了 UK Biobank 中躁狂或烦躁情绪 (N=42,183) 期间经历的症状模式。我们确定了一类经历了主要由抑郁/焦虑病例组成的主要易怒情绪的破坏性发作，以及一类自信心/创造力增强的个体报告较低的破坏性和较低的功能障碍。五个潜在类别在独立队列 PROTECT 研究 (N=4,445) 中复制，类别之间具有相似的区别。结论我们对个体进行分组的数据驱动方法确定了不同的潜在类别。