Using Personalized Network Models to Differentiate Between Unipolar and Bipolar Depression
Abstract
The so-called integration problem in psychiatry (i.e., how to create a unified model spanning biological, phenomenological, and sociological levels of description) hinders current understanding, research and treatment of psychiatric disorders [1]. It has been proposed that all relevant phenomena can be grouped into four dimensions that need to be integrated to gain relevant insight into the disorders: (1) Experiental dimension; the way we experience, (2) biological dimension; physiological processes of the brain and body, (3) sociocultural dimension; our relationships and environment and (4) existential dimension; reflexive stances we take towards our experience.
So far, explanatory models of psychiatric disorders that span multiple levels of analysis are rare. A proposed solution is the so-called Personalized Network Model (PNM) approach, a theoretical framework that integrates all 4 areas in a non-hierarchical and non-reductionistic way.
PNM is a network model that serves as a simplification of a complex dynamical system that represents a person. It is made out of nodes representing the relevant factors from all 4 dimensions that contribute to or alleviate the psychiatric problems of an individual and connections between the nodes that show the direction and strength of the relationship between factors.
In our research, we will create PNMs of our participants and treat each one as a separate case study. We will follow 6-8 participants that can be placed on a spectrum from normative population to expression of mood disorder symptomatology. Once per month for a year, qualitative data will be gathered for each person using Descriptive Experience Sampling (DES) method [2], followed by a micro-phenomenological interview. For data about the biological dimension, besides the participants reports on sleep, nutrition, and use of psychoactive substances, an EEG micro-state analysis will be made at regular intervals.
Our mains research question is: can we observe a difference between expressions of unilateral depression, better known as major depressive disorder and bipolar depression, a mood disorder characterized by depressive-manic episodes . What are the differences between the two is still a relevant question in psychiatry as current ways of differentiating are not satisfactory, and misdiagnosing bipolar patients as unipolar can be dangerous as recommended treatments for the disorders differ. For analysis we will use a bottom-up approach on a a larger data set than just our participants as we are working as a subset of a larger data gathering project that uses the same methods.
References[1] S. De Haan, “Enactive psychiatry,” Cambridge University Press, 2020.
[2] R. Hurlbert and S.Akhter, “The descriptive experience sampling method,” Phenomenology and the Cognitive sciences, vol. 5, no. 3, pp. 271-301, 2006.
