Analysis of Seasonal Variation Characteristics of Emotional Symptom Networks in 3445 Patients with Bipolar Disorder
10.13288/j.11-2166/r.2026.17.012
- VernacularTitle:3445例双相情感障碍患者四时情绪症状变化网络特征分析
- Author:
Ziyan LI
1
;
Hong ZHU
1
;
Hongxiao JIA
1
Author Information
1. Beijing Anding Hospital，Capital Medical University/ National Center for Mental Disorders，Beijing，100088
- Publication Type:Journal Article
- Keywords:
bipolar disorder;
emotional symptoms;
depression;
mania;
seasonal yin-yang;
growth phase;
storage phase
- From:
Journal of Traditional Chinese Medicine
2026;67(17):1877-1882
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the seasonal yin-yang waxing and waning characteristics of emotional symptoms in patients with bipolar disorder （BD） based on modern psychological symptom networks. MethodsClinical data of 3445 patients with BD were retrospectively collected and divided into a growth phase group （March to August） and a storage phase group （September to February of the following year） according to admission time. Ten symptom nodes were selected， including seven items from the Hamilton Depression Rating Scale （depressed mood， decreased work and interest， feelings of hopelessness， feelings of incapacity， difficulty falling asleep， restless sleep， and suicidal ideation） and three items from the Young Mania Rating Scale （elevated mood， increased activity/energy， and irritability）. The emotional symptom networks of the growth phase group and storage phase group were constructed using the EBICglasso model. Network comparison test （NCT） was used to compare network structural invariance （M）， global network strength invariance （S）， and differences in node centrality between the two groups. ResultsAmong the 3445 patients， 1604 were in the growth phase group and 1841 were in the storage phase group. After balancing covariates including admission year， admission mode， and episode type using inverse probability of treatment weighting （IPTW）， the emotional symptom networks of BD patients in the growth phase and storage phase groups showed similar overall structures， both presenting a two-cluster distribution composed of manic-related and depressive-related symptoms. No statistically significant difference was observed in network structure （M=0.103， P=0.181）. The global strength of the growth phase group （4.168） was slightly higher than 3.901 of the storage phase group， with no statistically significant difference （S=0.267， P=0.052）， suggesting that overall network connectivity remained relatively stable under the influence of seasonal qi dynamics. Node centrality analysis showed that depressed mood and increased activity/energy were common core nodes in both phases. Regarding directional changes， the strength of nodes including difficulty falling asleep， decreased interest， irritability， and increased activity showed a slight upward trend in the growth phase group， whereas the strength of suicidal ideation was slightly higher in the storage phase group； however， none of these differences reached statistical significance （P＞0.05）. ConclusionThe emotional symptom networks of BD patients remained generally stable between the growth and storage phases. Seasonal variations may induce only slight fluctuations in the centrality of certain symptoms but are insufficient to reconstruct the overall symptom network.
