目的：過往研究發現雙相情緒障礙症患者的活動量、睡眠及情緒特徵與健康族群有不一樣的模式，並且三者之間有其關聯性。後續研究持續探討其關聯性並認為個案之活動量為此疾病的核心，但至今未有定論。近年來科技的普及補足傳統醫療模式無法隨時隨地、連續的蒐集症狀變化的限制，亦可應用於雙相情緒障礙症領域研究。因此本研究欲使用手機應用程式以生態瞬間評估法探討雙相情緒障礙症患者情緒、睡眠及活動量之時序關聯性。方法：本研究運用本校護理系林靜蘭教授科技部計畫「運用智慧型手機通訊網絡於精神病患之早期偵測及介入」與資訊工程學系吳宗憲教授科技部計畫「日常互動影音與生活作息資訊之情緒追蹤及情緒異常預警之系統」(國立成功大學醫學院附設醫院人體研究倫理審查委員會編號：A-ER-106-229) 於2020/02/18至2021/03/29間所招募之159名雙相情緒障礙症患者之每日情緒、睡眠及活動量指標，採用重複計量相關分析以了解受試者每日、每週及每月間三變量間的時序關聯性。結果：159名雙相情緒障礙症患者之平均年齡為34.50，其中56%為女性，整個研究期間，受試者之HAMD分數平均為5.30分(SD=4.75)，YMRS分數平均為1.50分(SD=1.67)；ASRM分數平均為2.94分(SD=2.74)；DASS-21憂鬱分量表的平均分數為7.75分(SD=6.59)。以不同時序長度進行情緒、睡眠及活動量指標相關分析，結果顯示相同變項在任兩時序點間皆有顯著相關，但是不同變項在相鄰兩天間無顯著相關。當時序間隔以週為單位時，情緒與隔週的情緒和睡眠指標呈顯著正相關，睡眠和活動量與隔週的三項指標（情緒、睡眠、活動量）皆呈顯著正相關；當以月為單位時，情緒與隔月的情緒和活動量指標呈顯著正相關，睡眠與隔月的活動量和睡眠指標呈顯著正相關，而活動量與隔月的三項指標皆呈顯著正相關。結論：研究結果顯示了情緒、睡眠及活動量三個變項間時序關聯性不同。而其中情緒和睡眠與活動量的相關以及活動量與情緒和睡眠的相關在相鄰兩週與兩月時序相關中皆顯著的相關。此研究結果再次證實雙相情緒障礙症患者的活動量、睡眠及情緒之間有雙向相關，未來臨床介入時將嘗試給予個案行為活化介入以觀察其緩解雙相情緒障礙症患者症狀之效果。此外，亦將納入急性期的受試者，以了解不同嚴重程度的病患在情緒、睡眠及活動量上的時序關聯性是否相同。

The popularization of smart technology has provided the opportunity to continuously monitor phenotype changes digitally in real time. This project aimed to examine the relationships among activity levels, sleep pattern, and mood symptoms via a smartphone app in patients with bipolar disorder (BD). 159 BD outpatients were invited to install the app and used it. In addition to clinician-rated assessments, participants were asked to complete their daily wake/sleep time and emotional status in the app. Their daily activity data were collected automatically through GPS recording. We used repeated-measures correlation analysis to examine the possible correlations. Mood, sleep, and activity were all significantly correlated with the same variables on the next day, in the next week, or in the next month. Between two weeks or months, mood was positively correlated with activity, sleep was positively correlated with activity, and activity was positively correlated with mood and sleep. In accordance with previous studies, our results showed that activity, mood, and sleep duration influenced each other in patients with BD, but they influenced each other differently in different time frames. The influence of mood on activity was most significant.

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