Objectives: The aim of this study is to explore mania as a network of its symptoms, inspired by the network approach to mental disorders.
Methods: Network structures of both cross-sectional and temporal effects were measured at three time points (admission, middle of hospital stay, and discharge) in a sample of 100 involuntarily committed patients diagnosed with bipolar I disorder with severe manic features and hospitalized in a specialized psychiatric ward.
Results: Elevated mood is the most interconnected symptom in the network on admission, while aggressive behavior and irritability are highly predictive of each other, as well as language-thought disorder and "content" (the presence of abnormal ideas or delusions). Elevated mood is influenced by many symptoms in the temporal network.
Conclusions: The investigation of manic symptoms with network analysis allows for identifying important symptoms that are better connected to other symptoms at a given moment and over time. The connectivity of the manic symptoms evolves over time. Central symptoms could be considered as targets for clinical intervention when treating severe mania.
Keywords: Granger causality; bipolar disorders; centrality; network analysis.
© 2021 The Authors. Brain and Behavior published by Wiley Periodicals LLC.