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<p>Mania/hypomania, the pathognomonic feature of bipolar disorder (BD), is characterized by elevated impulsivity, often assessed via delay discounting—the preference for smaller, immediate versus larger, delayed rewards. It remains unclear whether delay discounting differentiates BD from non-BD individuals or serves as an objective behavioral marker of mania/hypomania versus depression risk. Bipolar disorder (<i>n</i> = 40) and non-BD (<i>n</i> = 187) individuals were recruited, with the latter encompassing a range of mania/hypomania and depression risk and stratified into mania/hypomania and depression risk tertiles. Kruskal-Wallis and Dunn’s tests evaluated delay discounting rates (<i>k</i> values), assessed via the 27-Item Monetary Choice Questionnaire, across both risk groups compared to the BD group. Significant group effects were found for overall and geomean <i>k</i> values in both mania/hypomania (overall <i>k</i>: χ<sup>2</sup>(3) = 8.15, <i>p</i> = 0.043; geomean <i>k</i>: χ<sup>2</sup>(3) = 8.40, <i>p</i> = 0.038) and depression risk groups (overall <i>k</i>: χ<sup>2</sup>(3) = 8.30, <i>p</i> = 0.04; geomean <i>k</i>: χ<sup>2</sup>(3) = 8.75, <i>p</i> = 0.033). Only <i>k</i> values for medium reward magnitudes were significant for both mood risk stratifications (corrected <i>α</i> = 0.05/3 = 0.0167). Bipolar disorder had significantly higher <i>k</i> versus low-risk mania/hypomania individuals (adjusted <i>p</i> = 0.012), as did high-risk versus low-risk mania/hypomania individuals (adjusted <i>p</i> = 0.039). Bipolar disorder had higher <i>k</i> versus high-risk depression individuals (adjusted <i>p</i> = 0.005), as did low-risk versus high-risk depression individuals (adjusted <i>p</i> = 0.029). Bipolar disorder had significantly higher <i>k</i> for medium reward magnitudes versus high-risk depression-only (<i>W</i> = 398, <i>p</i> &lt; 0.001), but not versus high-risk mania/hypomania-only (<i>W</i> = 587.5, <i>p</i> = 0.368) individuals. Delay discounting for medium reward magnitudes differentiates BD from non-BD individuals and distinguishes heightened mania/hypomania risk from depression risk, supporting its potential as an objective behavioral marker for mania/hypomania risk detection.</p>

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Reward magnitude-specific delay discounting differentiates mania versus depression risk

  • 期刊论文

  • 发表日期：

    2025年5月28日

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  • Robert Raeder,
  • Manan Arora,
  • Michele Bertocci,
  • Henry W. Chase,
  • Alexander S. Skeba,
  • Genna Bebko,
  • Haris A. Aslam,
  • Simona Graur,
  • Osasumwen Benjamin,
  • Yiming Wang,
  • Richelle Stiffler,
  • Mary L. Phillips

摘要

Mania/hypomania, the pathognomonic feature of bipolar disorder (BD), is characterized by elevated impulsivity, often assessed via delay discounting—the preference for smaller, immediate versus larger, delayed rewards. It remains unclear whether delay discounting differentiates BD from non-BD individuals or serves as an objective behavioral marker of mania/hypomania versus depression risk. Bipolar disorder (n = 40) and non-BD (n = 187) individuals were recruited, with the latter encompassing a range of mania/hypomania and depression risk and stratified into mania/hypomania and depression risk tertiles. Kruskal-Wallis and Dunn’s tests evaluated delay discounting rates (k values), assessed via the 27-Item Monetary Choice Questionnaire, across both risk groups compared to the BD group. Significant group effects were found for overall and geomean k values in both mania/hypomania (overall k: χ2(3) = 8.15, p = 0.043; geomean k: χ2(3) = 8.40, p = 0.038) and depression risk groups (overall k: χ2(3) = 8.30, p = 0.04; geomean k: χ2(3) = 8.75, p = 0.033). Only k values for medium reward magnitudes were significant for both mood risk stratifications (corrected α = 0.05/3 = 0.0167). Bipolar disorder had significantly higher k versus low-risk mania/hypomania individuals (adjusted p = 0.012), as did high-risk versus low-risk mania/hypomania individuals (adjusted p = 0.039). Bipolar disorder had higher k versus high-risk depression individuals (adjusted p = 0.005), as did low-risk versus high-risk depression individuals (adjusted p = 0.029). Bipolar disorder had significantly higher k for medium reward magnitudes versus high-risk depression-only (W = 398, p < 0.001), but not versus high-risk mania/hypomania-only (W = 587.5, p = 0.368) individuals. Delay discounting for medium reward magnitudes differentiates BD from non-BD individuals and distinguishes heightened mania/hypomania risk from depression risk, supporting its potential as an objective behavioral marker for mania/hypomania risk detection.