{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:04:40Z","timestamp":1782846280195,"version":"3.54.5"},"reference-count":28,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Ment Health"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Distinguishing pediatric bipolar disorder (BD) from attention-deficit\/hyperactivity disorder (ADHD) is challenging due to overlapping fluctuations in mood, energy, and activity. Combining objective actigraphy with self-reported mood and energy data may aid differential diagnosis and risk monitoring.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to test same-day associations between actigraphy-derived activity extremes and self-reported mood and energy, and to evaluate whether these measures predict same-day and next-day severe mood in adolescents with BD, ADHD, and other diagnoses.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We analyzed 209 inpatients (2148 patient-days) across 4 groups (ADHD without BD: n=54; BD with ADHD: n=42; BD without ADHD: n=34; other diagnoses: n=79). Actigraphy data (Philips Actiwatch 2) were summarized into daily maximum and minimum quartiles (Max1-Max4 and Min1-Min4). Mood and Energy Thermometer (\u221210 to +10) ratings were categorized as follows: OK (<3), mild (3\u20104), moderate (5\u20106), and severe (>6). Group differences used Kruskal-Wallis and Mann-Whitney\n U<\/jats:italic>\n tests with Bonferroni correction (\n P<\/jats:italic>\n <.004). Associations used chi-square tests\n \n with Cram\u00e9r V. Leak-safe machine learning (patient-wise GroupKFold) classified SevereDay (same day) and SevereTomorrow (next day) using actigraphy, sleep, energy, and demographic data.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n BD without ADHD showed the tightest coupling of extreme activity with negative mood and energy (Cram\u00e9r V of up to 0.24;\n P<\/jats:italic>\n <.004). ADHD without BD showed stronger links between activity and positive energy. Machine learning achieved a receiver operating characteristic area under the curve (ROC-AUC) of 0.85, an accuracy of 0.79, and an\n F<\/jats:italic>\n 1<\/jats:sub>\n -score of 0.67 for SevereDay. SevereTomorrow performance was moderate (ROC-AUC=0.80; accuracy=0.79;\n F<\/jats:italic>\n 1<\/jats:sub>\n -score=0.60). Energy variability and actigraphy averages\/peaks were the top predictors.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Integrating actigraphy, sleep, and daily energy ratings identifies severe mood days and provides early next-day risk signals in hospitalized adolescents. The findings support wearable-based phenotyping for precision monitoring, with external validation needed in outpatients.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/78163","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T11:25:06Z","timestamp":1758194706000},"page":"e78163-e78163","source":"Crossref","is-referenced-by-count":0,"title":["Differentiating Pediatric Bipolar Disorder, Attention-Deficit\/Hyperactivity Disorder, and Other Psychopathologies Using Self-Reported Mood and Energy Data and Actigraphy Findings: Correlation and Machine Learning\u2013Based Prediction of Mood Severity"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5895-6572","authenticated-orcid":false,"given":"Rasim S","family":"Diler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0803-7831","authenticated-orcid":false,"given":"Farzan","family":"Vahedifard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-6519","authenticated-orcid":false,"given":"Boris","family":"Birmaher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9329-6853","authenticated-orcid":false,"given":"Satish","family":"Iyengar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2385-4379","authenticated-orcid":false,"given":"Maria","family":"Wolfe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6541-7948","authenticated-orcid":false,"given":"Brianna N","family":"Lepore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3118-8432","authenticated-orcid":false,"given":"Mariah","family":"Chobany","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6560-2816","authenticated-orcid":false,"given":"Halimah","family":"Abdul-Waalee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6641-6733","authenticated-orcid":false,"given":"Greeshma","family":"Malgireddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0825-2587","authenticated-orcid":false,"given":"Jonathan A","family":"Hart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3857-1226","authenticated-orcid":false,"given":"Michele A","family":"Bertocci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"issue":"3","key":"R1","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1111\/camh.12021","article-title":"Bipolar disorder in children and adolescents","volume":"18","author":"Birmaher","journal-title":"Child Adolesc Ment Health"},{"issue":"2","key":"R2","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1007\/s10803-009-0804-6","article-title":"Rasim Somer Diler (ed): pediatric bipolar disorder: a global perspective","volume":"40","author":"Kleinman","journal-title":"J Autism Dev Disord"},{"issue":"2","key":"R3","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1038\/mp.2013.116","article-title":"Independence of familial transmission of mania and depression: results of the NIMH family study of affective spectrum disorders","volume":"19","author":"Merikangas","journal-title":"Mol Psychiatry"},{"key":"R4","unstructured":"Barkley RA Murphy KR Fischer M . 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