[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-123591-en":3,"doc-seo-123591-105":30,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":4,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},123591,1099513958762,"Logic","https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1784791008015729253",7,"Healthcare","Identifying the bridge between depression and mania - A machine learning and network approach to bipolar disorder","Objectives: Although bipolarity is inherently cyclic, prior work has rarely examined how the two poles relate using network psychometrics. The study uses modern network and machine learning approaches to identify depression and mania symptoms, and the symptom relationships that connect them. Methods: An observational analysis of Canadian Community Health Survey 2002 mental health data with 12 depression and 12 mania symptoms (N=36,557) applies network psychometrics plus a random forest model to test bidirectional interplay. Results and conclusions: Centrality highlights key emotional and hyperactivity symptoms, while sleep disturbance, anhedonia, suicidal ideation, and impulsivity form a bridge.","This is a repository copy of Identifying the bridge between depression and mania: a machine learning and network approach to bipolar disorder.  \nWhite Rose Research Online URL for this paper:  \n[https://eprints.whiterose.ac.uk/197501/](https://eprints.whiterose.ac.uk/197501/)  \nVersion: Published Version  \nArticle:  \nZavlis, [O. orcid.org/0000-0002-3985-6346](O. orcid.org/0000-0002-3985-6346) , Matheou, A. and Bentall, R. (2023) Identifying the bridge between depression and mania: a machine learning and network approach to bipolar disorder. Bipolar Disorders. ISSN 1398-5647  \n[https://doi.org/10.1111/bdi.13316](https://doi.org/10.1111/bdi.13316)  \nReuse  \nThis article is distributed under the terms of the Creative Commons Attribution (CC BY) licence. This licence allows you to distribute, remix, tweak, and build upon the work, even commercially, as long as you credit the authors for the original work. More information and the full terms of the licence here: [https://creativecommons.org/licenses/](https://creativecommons.org/licenses/)  \nTakedown  \nIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by  \nemailing [eprints@whiterose.ac.uk](eprints@whiterose.ac.uk) including the URL of the record and the reason for the withdrawal request.  \n[eprints@whiterose.ac.uk](eprints@whiterose.ac.uk)[ ](eprints@whiterose.ac.uk)[https://eprints.whiterose.ac.uk/](https://eprints.whiterose.ac.uk/)  \nDOI: 10. 1111/bdi.13316  \nOR I G I NA L A RT I C L E  \nIdentifying the bridge between depression and mania:  \nA machine learning and network approach to bipolar disorder  \nOrestis Zavlis1  | Andreas Matheou2 | Richard Bentall3  \n1University of Manchester, Department of Social Statistics, Manchester, UK 2University of Manchester, Manchester Medical School, Manchester, UK 3University of Sheffield, Department of Clinical Psychology, Sheffield, UK  \nCorrespondence  \nOrestis Zavlis, The University of Manchester, Department of Social Statistics, Humanities Bridgeford Street, M15 6GY, Manchester, UK. [Email: orestis. research@gmail.com](Email: orestis. research@gmail.com)  \nAbstract  \nObjectives: Although the cyclic nature of bipolarity is almost by definition a network system, no research to date has attempted to scrutinize the relationship of the two bipolar poles using network psychometrics. We used state-of-the-art network and machine learning methodologies to identify symptoms, as well as relations thereof, that bridge depression and mania.  \nMethods: Observational study that used mental health data (12 symptoms for depression and 12 for mania) from a large, representative Canadian sample (the Canadian Community Health Survey of 2002) . Complete data (N = 36,557; 54. 6% female) were analysed using network psychometrics, in conjunction with a random forest algorithm, to examine the bidirectional interplay of depressive and manic symptoms. Results: Centrality analyses pointed to symptoms relating to emotionality and hyperactivity as being the most central aspects of depression and mania, respectively. The two syndromes were spatially segregated in the bipolar model and four symptoms appeared crucial in bridging them: sleep disturbances (insomnia and hypersomnia), anhedonia, suicidal ideation, and impulsivity. Our machine learning algorithm validated the clinical utility of central and bridge symptoms (in the prediction of lifetime episodes of mania and depression), and suggested that centrality, but not bridge, metrics map almost perfectly onto a data-driven measure of diagnostic utility.  \nConclusions: Our results replicate key findings from past network studies on bipolar disorder, but also extend them by highlighting symptoms that bridge the two bipolar poles, while also demonstrating their clinical utility. If replicated, these endophenotypes could prove fruitful targets for prevention/intervention strategies for bipolar disorders.  \nK E Y WO R D S  \nbipolarity, depression and mania, epidemiology, mach","cbCail5CLO02fKVA","https://ap.wps.com/l/cbCail5CLO02fKVA","pdf",3070711,1,13,"English","en",105,"# Introduction\n## Objectives\n## Methods\n## Results\n## Conclusions","[{\"question\":\"What is the main objective of this study?\",\"answer\":\"To identify depression and mania symptoms and uncover the symptom connections that bridge the two bipolar poles using network psychometrics and machine learning.\"},{\"question\":\"How were the data and analysis conducted?\",\"answer\":\"The study analyzed mental health data from the Canadian Community Health Survey (2002) using network psychometrics and a random forest algorithm to examine bidirectional interplay.\"},{\"question\":\"Which symptoms were found to be crucial for bridging depression and mania?\",\"answer\":\"Sleep disturbances (insomnia and hypersomnia), anhedonia, suicidal ideation, and impulsivity were reported as crucial bridge symptoms.\"}]","Identifying the bridge between depression and mania - A machine learning and network approach to bipolar disorder | PDF",1785817524,33,{"code":4,"msg":31,"data":32},"ok",{"site_id":24,"language":23,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":86,"head_meta":88,"extra_data":90,"updated_unix":28},"identifying-the-bridge-between-depression-and-mania-a-machine-learning-and-network-approach-to-bipolar-disorder","",{"@graph":36,"@context":85},[37,54,68],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/healthcare/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/identifying-the-bridge-between-depression-and-mania-a-machine-learning-and-network-approach-to-bipolar-disorder/123591/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":23,"description":14,"dateModified":62,"datePublished":62,"encodingFormat":61,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-08-04",true,{"@type":65,"interactionType":66,"userInteractionCount":4},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71,77,81],{"name":72,"@type":73,"acceptedAnswer":74},"What is the main objective of this study?","Question",{"text":75,"@type":76},"To identify depression and mania symptoms and uncover the symptom connections that bridge the two bipolar poles using network psychometrics and machine learning.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"How were the data and analysis conducted?",{"text":80,"@type":76},"The study analyzed mental health data from the Canadian Community Health Survey (2002) using network psychometrics and a random forest algorithm to examine bidirectional interplay.",{"name":82,"@type":73,"acceptedAnswer":83},"Which symptoms were found to be crucial for bridging depression and mania?",{"text":84,"@type":76},"Sleep disturbances (insomnia and hypersomnia), anhedonia, suicidal ideation, and impulsivity were reported as crucial bridge symptoms.","https://schema.org",{"og:url":52,"og:type":87,"og:title":13,"og:site_name":59,"og:description":14},"article",{"robots":89,"canonical":52},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":92},[93,97,101,105,110,115,118,123,128,131,135],{"id":20,"doc_module":4,"doc_module_name":46,"category_name":94,"show_sort_weight":95,"slug":96},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":98,"show_sort_weight":99,"slug":100},"Literature",80,"literature",{"id":53,"doc_module":4,"doc_module_name":46,"category_name":102,"show_sort_weight":103,"slug":104},"Exam",70,"exam",{"id":106,"doc_module":4,"doc_module_name":46,"category_name":107,"show_sort_weight":108,"slug":109},5,"Comic",60,"comic",{"id":111,"doc_module":4,"doc_module_name":46,"category_name":112,"show_sort_weight":113,"slug":114},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":116,"slug":117},40,"healthcare",{"id":119,"doc_module":4,"doc_module_name":46,"category_name":120,"show_sort_weight":121,"slug":122},8,"Research & Report",30,"research-report",{"id":124,"doc_module":4,"doc_module_name":46,"category_name":125,"show_sort_weight":126,"slug":127},9,"Religion & Spirituality",20,"religion-spirituality",{"id":126,"doc_module":4,"doc_module_name":46,"category_name":129,"show_sort_weight":126,"slug":130},"World Cup","world-cup",{"id":132,"doc_module":4,"doc_module_name":46,"category_name":133,"show_sort_weight":132,"slug":134},10,"Lifestyle","lifestyle",{"id":136,"doc_module":4,"doc_module_name":46,"category_name":137,"show_sort_weight":106,"slug":138},19,"General","general"]