Observational study reveals mood instability worsens clinical outcomes across diverse mental health disorders, suggesting transdiagnostic screening is needed.
Key Points
To evaluate the prevalence of mood instability and its impact on clinical outcomes across a broad cohort of adults receiving secondary mental healthcare.
Observational study using an anonymized electronic health record case register from the South London and Maudsley NHS Trust (SLaM) in the UK.
Analyzed 27,704 adults presenting between April 2006 and March 2013 with psychotic, affective, or personality disorders.
Identified mood instability within 1 month of presentation using natural language processing (NLP) and tracked outcomes over a 5-year follow-up period.
Mood instability was documented in 12.1% of patients overall, occurring most frequently in bipolar disorder (22.6%), personality disorder (17.8%), and schizophrenia (15.5%).
Mood instability was associated with more days spent in hospital (β coefficient 18.5, 95% CI 12.1 to 24.8), increased frequency of hospital admission (incidence rate ratio 1.95, 95% CI 1.75 to 2.17), and higher likelihood of compulsory admission (OR 2.73, 95% CI 2.34 to 3.19).
Presence of mood instability was associated with increased prescription likelihood of antipsychotics (OR 2.03, 95% CI 1.75 to 2.35) and non-antipsychotic mood stabilisers (OR 2.07, 95% CI 1.77 to 2.41).