Actigraph data as a biomarker of affective instability: imparseable but important G Murray a , B Bullock a , P Indic b , F Judd c a Swinburne University of Technology, Melbourne, Australia, b University of Massachusetts, Worcester, MA, USA, c University of Melbourne, Melbourne, Australia Background: Biological rhythm disturbance is involved in the course of bipolar disorder (BD), and a biomarker of biological rhythm instability would be clinically useful. Actigraphy has received insufficient attention because it is the complex endpoint of circadian, sleep, and social factors. We postulated that, as long as this inferential complexity is recognized, actigraph data has potential as a biomarker of BD. Methods: In Study 1, traitlike affective instability was measured on the General Behaviour Inventory, and two groups of high (N = 35) and low (N = 35) vulnerability healthy young adults were compared. In Study 2, a clinical sample (N = 15) and matched healthy controls (N = 15) were compared. In Studies 1 and 2, wavelet analysis was used to generate a multi-scale activity parameter for each person. In Study 3, daily actigraph parameters were used to predict within-subject fluctuations of mood state in a clinical sample (N = 11) monitored longitudinally for an average of 133.7 days. Results: High and low vulnerability subjects were significantly differentiated by the shape parameter of a multi-scale function F(1,68) = 12.15, p < 0.01 (Study 1). Study 2 data is currently being analysed. In Study 3, long-term actigraphy was found to be well tolerated, and DActivity significantly predicted DMood in hierarchical linear modelling analyses, t(755) = 3.84, p < 0.001. Conclusions: Non-linear signals in actigraph data may act as nonintrusive trait and state biomarkers of BD. Although actigraph data cannot be parsed into constituent drivers, it contains signals that are clinically important. Addressing the need for a disorder-specific quality of life scale for bipolar disorder: psychometric properties of the quality of life in bipolar disorder (QoL.BD) G Murray a , EE Michalak b a Swinburne University of Technology, Melbourne, Australia, b University of British Columbia, Vancouver, Canada Introduction: There is currently no accepted disorder-specific measure of quality of life (QoL) in bipolar disorder (BD). This paper reports on a four-year mixed-method, patient-centred program of research to develop such a measure. Methods: The project was informed by standard protocols for the development of disorder-specific QoL measures. Item generation involved a qualitative investigation of individuals with BD, caregivers, and relevant experts (Study 1, N = 52), as well as a literature review. Item reduction analyses involved an impact method analysis with affected individuals (Study 2, N = 28), a large field sample (Study 3, N = 225, including a repeated measures subset [n = 93]) and a final intensive item reduction study, again involving individuals with BD and experts in the area (Study 4, N = 31). Results: A 56-item, 14 domain measure (the QoL.BD) was developed and tested for psychometric properties. Internal reliability of subscales was found to be excellent, test-retest reliability was appropriate, and correlations with external measures consistent with theory. Exploratory factor analyses suggested adequate correspondence between the instrument’s latent and surface structure. Analysis of sensitivity to clinical change suggested that the QoL.BD explains additional variance over and above commonly used generic measures of QoL. Discussion: Complete Phase I field testing suggests that the QoL.BD meets the urgent need for a disorder-specific measure of quality of life in BD. The latent structure of the instrument awaits confirmation in an independent sample, and further research will investigate its sensitivity to clinical change. Multimodal measurement of impulsivity in adolescents with bipolar disorder versus adolescents with ADHD JJ Nandagopal, MP DelBello, DE Fleck, SM Strakowski University of Cincinnati, Cincinnatti, OH, USA Objectives: To determine if adolescents with bipolar disorder (BD) perform differently from adolescents with attention deficit- hyperactivity disorder (ADHD) and healthy controls (HC) on a behavioral measure of impulsivity, the Continuous Performance Task-Identical Pairs (CPT-IP)-degraded version and a self-report measure of impulsivity, the Barratt Impulsiveness Scale (BIS-11), during manic and euthymic states. Methods: Adolescents with ADHD without other co-morbidities (n = 28), BD manic/mixed adolescents (n = 33), BD euthymic adolescents (n = 20), and HC (n = 25) were administered the CPT- IP and BIS-11. We compared performance variables (perceptual sensitivity, hit reaction time (RT) and response bias) at two degradation levels (high, low) on CPT-IP and total and subscale (cognitive, motor, nonplanning) scores on BIS-11 between the groups. Results: No significant group differences were noted in response bias and perceptual sensitivity (p > 0.05). Hit RT was equal amongst groups under low degradation, but a marginally significant difference was noted between the ADHD and BD euthymic groups (ADHD group was slower than BD euthymic group) under high degradation (p = 0.053). The HC group scored significantly lower than the other three groups (p < 0.05) on non-planning, cognitive, and total BIS-11 scores, but, on motor subscale, HC and BD euthymic groups had statistically similar scores (p = 0.12). Conclusions: It appears that when bipolar patients achieve euthymia, their motor impulsivity decreases, thereby, improving attention and processing efficiency. Although impulsivity is a prominent feature of BD and ADHD, only motor aspects of impulsivity may be useful to distinguish between them. The potential for impulsivity in BD patients appears to be high even when their mood appears to be stable. Cognitive assessment in a crack users population with and without mood disorders: a pilot study JM Narvaez a , BS Fernandes b , DC Vieira a , JF Tramontina a , EK Trindade c , NS Kapczinski a , M Kauer-SantÕAnna d , FP Kapczinski d a Hospital de Clı´nicas de Porto Alegre, Porto Alegre, Brazil, b Bipolar Disorder Program, Hospital de Clı´nicas de Porto Alegre, Porto Alegre, Brazil, c Instituto de Diagno ´stico e Tratamento em Psicologia Prof. Jorge Trindade, Porto Alegre, Brazil, d INCT Translational Medicine, Porto Alegre, Brazil Introduction: Cocaine use and mood disorders are two frequent psychiatric comorbidities. There are few prevalence studies and cognitive functions assessment in patients with mood disorders, particularly bipolar disorder (BD), in crack users. Methods: Fifty-one outpatient crack users under treatment in Cruz Vermelha, Porto Alegre, Brazil. All patients were assessed by SCID-I. A neuropsychological battery using some sub-tests of the Wechsler Adult Intelligence Scale and Wisconsin Card Sorting Test was also administered. Results: Abstinence for at least six months was seen in 15.70% of the patients. Forty-six of the 51 patients were male. The mean age of the sample was 30.39 ± 8.49. The prevalence of mood disorders was 43.1% (22 subjects). Of those, seven were patients with BD, and 15 patients had the diagnosis of major depression or Abstracts ª 2010 The Authors 40 Journal compilation ª 2010 John Wiley & Sons A / S, Bipolar Disorders, 12 (Suppl. 1), 1–65