Preliminary communication Treatment for depression and change in mood instability Rudy C. Bowen a, ⁎, Jan Mahmood b , Ali Milani c , Marilyn Baetz a a University of Saskatchewan, Canada b Prairie North Health Region, Saskatchewan, Canada c Cypress Health Region, Saskatchewan, Canada article info abstract Article history: Received 4 June 2010 Accepted 29 June 2010 Available online 31 July 2010 Background: Mood varies along at least 2 dimensions, severity and instability (MI). Compared with severity, there is little research on the treatment of MI. We assessed changes in MI with community psychiatric treatment, in patients with depression and mood swings. Method: Diagnoses were obtained with the MINI. Thirty-four patients completed the Mood Disorders Questionnaire, the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-T). MI was calculated from visual analogue scales (VAS) ratings for depression and anxiety. The VAS was rated twice a day for a week. The BDI, STAI-T and VAS were repeated after 3–6 months of treatment. Results: Patients improved with treatment on depression (BDI) and anxiety (STAI-T) severity but not on MI. However, change in MI predicted change in depression severity (BDI). Limitations: The sample size was relatively small and information on treatment waslimited. There was no control group. Studies of longer duration and with more comprehensive treatment might be necessary to show changes in MI. Conclusions: MI does not respond consistently within 3–6 months to common effective psychiatric treatments for depression and anxiety. Improved treatment of MI could result in improved treatment for major depression. © 2010 Elsevier B.V. All rights reserved. Keywords: Mood instability Treatment Depression Anxiety 1. Introduction The criteria for an episode of Major Depression require that one of the cardinal symptoms be present “most of the day, nearly every day” (American Psychiatric Association, 2000). The assessment is usually made retrospectively, which involves mentally averaging mood over two weeks or longer and implies relative stability to the symptoms (American Psychiatric Association, 2000; Solhan et al., 2009). In contrast, when patients with major depression are asked to frequently and prospectively monitor their moods, they show higher point-to-point mood instability (MI) than normal controls (Benedetti et al., 1996; Bowen et al., 2006; Ebner-Priemer et al., 2009). Mood instability (MI) has been associated with low self-esteem (Franck and De Raedt, 2007), borderline traits (Ebner-Priemer et al., 2009) and unhappiness (Hills and Argyle, 2001), as well as with anxiety disorders (Bowen et al., 2006), depression (Heiby et al., 2003) and alcohol abuse (Bowen et al., 2008). MI has been shown to be a relatively stable personality trait (Eid and Diener, 1999; Murray et al., 2002) that correlates modestly with NEO-FFI neuroticism in the general population and in depressed patients (Eid and Diener, 1999; Murray et al., 2002; Tang et al., 2009). Neuroticism is a predictor of the occurrence of depression (Caspi et al., 1996) and the recurrence of depression after treatment (Tang et al., 2009). Few studies have examined the effects of MI on the psychiatric treatment of depressed patients and most studies have used self-report retrospective measures of neuroticism (Clark et al., 2003; Beevers and Miller, 2004; Brown, 2007; Tang et al., 2009). In this study we examined whether treatment of Journal of Affective Disorders 128 (2011) 171–174 ⁎ Corresponding author. Department of Psychiatry, 103 Hospital Drive, Saskatoon, SK, Canada S7N0W8. Tel.: +1 306 966 8229; fax: +1 306 966 8177. E-mail address: r.bowen@usask.ca (R.C. Bowen). 0165-0327/$ – see front matter © 2010 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2010.06.040 Contents lists available at ScienceDirect Journal of Affective Disorders journal homepage: www.elsevier.com/locate/jad