Impulsivity in tramadol dependence and bipolar I disorder patients: a comparative study

Abstract

Background Tramadol has become widespread in Egypt. Impulsivity is recognized as a factor in the initiation and maintenance of substance use disorders. Moreover, bipolar disorder (BD) is commonly associated with impulsivity. Impulsivity seems to be relatively independent of mood state and is higher in individuals with past history of substance use. So, comparing impulsivity in BD and tramadol dependence is needed to determine if there is any difference. Impulsivity was evaluated by the Barratt Impulsiveness Scale in 30 male patients with BD in partial remission without any comorbid substance use disorder and age-matched 30 male patients with tramadol dependence in partial remission. Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID1), addiction severity index, Young Mania Rating Scale, andEysenck’s Personality Questionnaire were used.Results There was no difference among BD and tramadol dependence groups of patients on subscales attentional and motor impulsivity measures. However, the male tramadol dependence patient group scored higher than the male BD patient group for total and nonplanning impulsivity scores.Conclusion This study found that BD and tramadol dependence patients were similar on attention and motor impulsivity subscales but on the total score and nonplanning subscale, patients with tramadol dependence are more impulsive than patients with BD. Increased tendency to criminal behavior is associated with the increase in total and motor scores of Barratt Impulsiveness Scale in tramadol dependence patients as well as with the total scores of Young Mania Rating Scale in BD patients. Moreover, the severity of mania is correlated with the attentional domain of impulsivity.