Irritability in the Mix: An Exploratory Study of the Role of Irritability in Characterising Mood Disorders.

Erica Bell, Maree Inder, Gin S Malhi, Richard Bryant, Philip Boyce, Richard J Porter

Abstract readRandomized Controlled Trial

In one paragraph

Trial report in Bipolar disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Erica BellAcademic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-8483-8497

Maree InderDepartment of Psychological Medicine, University of Otago, Christchurch, New Zealand.ORCID https://orcid.org/0000-0002-6326-6100

Gin S MalhiAcademic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-4524-9091

Richard BryantSchool of Psychology, University of New South Wales, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-9607-819X

Philip BoyceSpeciality of Psychiatry, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-9816-7356

Richard J PorterDepartment of Psychological Medicine, University of Otago, Christchurch, New Zealand.ORCID https://orcid.org/0000-0002-8695-3966

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo examine the relationship between irritability and mixed states in bipolar disorder to determine how subjective irritability and mixed symptoms of mania and depression manifest in patients with bipolar disorder over a period of 18 months.

methodsThis exploratory analysis examined longitudinal data from a randomised controlled trial of a psychological intervention for patients with bipolar disorder. Scores of subjective irritability and mood morbidity were analysed from data sampled over ten timepoints over the trial from 82 patients.

resultsSignificant associations were found between the presence of irritability and mixed symptoms (F(1, 684) = 20.468, p < 0.001). This relationship remained significant throughout the duration of the study and the administration of a psychological treatment which reduced both ratings of mood and irritability. Notably, when mixed symptoms are absent, irritability nevertheless remained for nearly half the time.

conclusionsIrritability and mixed symptoms are phenomenologically linked. The persistence of this link, regardless of the existence of mixed symptoms, suggests that irritability permeates bipolar disorder and is core to its phenomenology. Future studies should interrogate the tethering of mixed symptoms and irritability in the context of bipolar disorder as this may lead to a deeper understanding of the core characteristics of the illness-both clinically and in terms of its neurobiology.

Indexed as

Bipolar DisorderIrritable MoodMood DisordersAdultFemaleHumansLongitudinal StudiesMaleMiddle AgedPsychiatric Status Rating Scalesbipolar disorderirritabilitymixed statesphenomenologypsychological treatment

Identifiers

PMID42813568

DOI10.1111/bdi.70185

PMCPMC13625195

What Socratic holds

Textmetadata

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 Socratic graph.