Impulsivity In Bipolar Disorder Research Articles

Impulsivity and neural correlates of response inhibition in bipolar disorder and their unaffected relatives: A MEG study

BackgroundResponse inhibition is a core cognitive impairment in bipolar disorder (BD), leading to increased impulsivity in BD. However, the relationship between the neural mechanisms underlying impaired response inhibition and impulsivity in BD is not yet clear. Individuals who are genetically predisposed to BD give a way of identifying potential endophenotypes. MethodsA total of 97 participants, including 39 patients with BD, 22 unaffected relatives (UR) of patients with BD, and 36 healthy controls performed a Go/No-Go task during magnetoencephalography. We carried out time-frequency and connectivity analysis on MEG data. ResultsDecreased beta power, prolonged latency and increased peak frequency in rIFG, decreased beta power in pre-SMA and reduced rIFG-to-pre-SMA connectivity were found in BD relative to healthy controls. In the UR group, we found a decrease in the beta power of pre-SMA and prolonged latency of rIFG. Furthermore, increased motor impulsiveness in BD was related to abnormal alterations in beta oscillatory activity of rIFG and functional connectivity between rIFG and pre-SMA. ConclusionsHypoactivity activity in rIFG and impaired dominant role of rIFG in the prefrontal control network may underlie the neuropathology of response inhibition dysfunction, resulting increased motor impulsivity in BD. Our findings point to measuring rIFG dysfunction as a potential means of identifying individuals at genetic high risk for transition to BD disease expression.

Difficulties in Emotion Regulation: Are They the Preventable Cause of Suicide, Impulsivity, and Aggression in Schizophrenia and Bipolar Disorder?

Difficulties in emotion regulation have begun to be seen as the source of psychopathologies. It is one of the underlying factors of patients' suicidality, impulsivity, and aggression. This study aims to determine the difficulties in emotion regulation in schizophrenia (SZ) and bipolar disorder (BD) patients and their relationship with suicidality, aggression, and impulsivity. It also emphasizes the importance of emotion regulation in these patients. 52 healthy individuals, 58 BD, and 55 SZ patients in remission were included in the study. The participants were informed before the study, and their written consent was obtained. Suicide Probability Scale (SPS), Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsivity Scale (BIS-11), and Buss-Perry Aggression Questionnaire (BPAQ) were administered to all three groups. DERS scores of patients with BD and SZ were higher than healthy individuals. SPS scores of patients with BD and SZ were higher than healthy individuals. The motor and total scores of the Barratt Impulsivity Scale (BIS-11) were higher in patients with BD than in patients with SZ and healthy individuals. According to Spearman correlation analysis, a significant positive relationship was found between all subscales of DERS and all subscales of SPS; physical aggression, anger, and hostility subscales of BPAQ; attention and motor subscales of BIS-11. Suicidality may increase in patients with schizophrenia and bipolar disorder who have difficulty in emotion regulation. Determining the difficulties of emotion regulation may contribute to the presumption and prevention of suicides in BD and SZ patients with a high risk of death by suicide.

Mindfulness, Attention, and Impulsivity in Bipolar Disorder

IntroductionBipolar disorder (BD) is a chronic mental disorder characterized by mood instability1. BD is further related to neurocognitive and functional disruptions that remain remarkably stable even when patients are euthymic, leading to poor well-being and quality of life. Mindfulness means paying attention on purpose, in the present moment, and involves different facets such as observing, describing, acting with awareness, non-judging and non-reacting of inner experience. It remains unclear whether mindfulness and its specific facets are differentially associated with different aspects of attention and trait impulsivity in individuals with BD.ObjectivesTo examine associations between different mindfulness facets, and different aspects of attention and trait impulsivity in BD.MethodsThis study was approved by the Hospital Clínic Ethics and Research Board (HCB/2017/0432). After informed consent, 94 outpatients, M age = 45.57, SD = 9.8, range 19-61 years, 41.5% Male, 63.8% BD-I according to DSM-5 criteria, in partial or total remission based on Young Mania Rating Scale (YMRS; M = 1.81, SD = 2.11) and Hamilton Depression Rating Scale (HDRS; M = 5.46, SD = 3.71) were enrolled in this study. Participants were evaluated using the Five Facet Mindfulness Questionnaire (FFMQ) to assess Mindfulness, the Trail Making Test (TMT-A) and the Conner’s Continuous Performance test (CPT-II) to assess Attention, and the Barratt Impulsiveness Scale (BIS-11) to assess Impulsivity. Pearson correlations were performed, and statistical significance was evaluated two-sided at the 5% threshold.ResultsMindfulness-Describing was negatively associated with Cognitive and Non-Planning Impulsivity (r = -.43 and -.28, p < .001), Mindfulness-Acting with Awareness was negatively associated with Cognitive, Motor and Non-Planning Impulsivity (r = -.27 to -.45, p < .001), Mindfulness Non-Judging (r = -.33 and -.34, p < .001) and Non-Reacting (r = -.30 and -.46, p < .001) of inner experience were negatively associated with Cognitive and Motor Impulsivity. No associations were found between neither Mindfulness nor Impulsivity with any aspects of Attention.ConclusionsPreliminary findings suggest that better performance in specific facets of mindfulness (describing, acting with awareness, non-judging or reacting of inner experience) may be related to a decrease in different aspects of trait impulsivity. Further longitudinal and interventional research is needed on underlying mechanisms. Nonetheless, our study suggests the need for including mindfulness-based approaches to improve behavioral and functional outcomes for those with BD.FundingThis work was supported by the European Union Horizon 2020 research and innovation program (EU.3.1.3. Treating and managing disease: Grant 945151), CIBERSAM, FIS PI17/00941 ISCIII, European Regional Development Fund.

The interplay of daily affect and impulsivity measured by mobile surveys in bipolar disorder

BackgroundImpulsivity is a prominent feature of bipolar disorder associated with various negative sequelae; moreover, it may be a precursor to shifts in affect or mood, but little is known about its association with affect on a day-to-day timescale. Ecological momentary assessments (a method that captures moment-to-moment ratings of psychological states by repeatedly sampling the same individual) of impulsivity and affect using mobile surveys allow for more nuanced examination of mechanisms of mood and behavior dysregulation. However, few existing studies have validated an ecological momentary assessment of impulsivity in bipolar disorder and examined its time-lagged associations with positive and negative affect. 70 participants with bipolar disorder and 102 healthy comparisons participated in an intensive longitudinal study: they underwent 14 days of ecological momentary assessment data collection annually for 1–4 years. Multiple measures of impulsivity and affect were collected using self-report, behavioral, and ecological momentary assessment modalities; these measures were compared, and levels of impulsivity were compared between bipolar disorder and healthy comparison groups. Time-lagged analyses using daily means explored the next-day predictive relationship of impulsivity on positive/negative affect, and vice versa.ResultsThe ecological momentary measure of impulsivity was moderately correlated with the self-report but not behavioral impulsivity measure. Bipolar disorder participants evinced higher self-report, behavioral, and daily impulsivity than healthy comparison participants. Time-lagged analyses revealed a bi-directional association between high impulsivity and high next-day negative (but not positive) affect. Post hoc analyses showed that impulsivity specifically predicted next-day anger and anxiety.ConclusionsOur multimodal assessment of impulsivity allowed for an examination of the day-to-day course of impulsivity and affect, crucial steps toward understanding the mechanisms of mood symptom and episode onset in bipolar disorder.

Impulsivity in Bipolar Disorder: State or Trait?

Impulsive behaviour is a key characteristic of mania in bipolar disorder (BD). However, there is mixed evidence as to whether impulsivity is a trait feature of the disorder, present in the euthymic state in the absence of mania. The aim of this systematic review and meta-analysis was to examine whether impulsivity is elevated in euthymic BD in comparison to controls. Electronic databases were searched for papers published until April 2022 reporting data on a self-report or behavioural measure of impulsivity in a euthymic BD group and a healthy control group. In total, 46 studies were identified. Euthymic BD showed significantly higher levels of self-reported impulsivity compared to controls (large effect size). Euthymic BD also showed significantly higher levels of impulsivity on response inhibition and inattention tasks, with moderate and large effect sizes, respectively. Only two studies measured delay of gratification, finding no significant differences between groups. Our results suggest impulsivity may be a trait feature of BD, however longitudinal cohort studies are required to confirm whether elevated impulsivity is present before illness onset. Future research should establish whether cognitive interventions are beneficial in improving impulsivity in BD.

The Influence of 5-HTTLPR, BDNF Rs6265 and COMT Rs4680 Polymorphisms on Impulsivity in Bipolar Disorder: The Role of Gender.

Impulsivity has been proposed as an endophenotype for bipolar disorder (BD); moreover, impulsivity levels have been shown to carry prognostic significance and to be quality-of-life predictors. To date, reports about the genetic determinants of impulsivity in mood disorders are limited, with no studies on BD individuals. Individuals with BD and healthy controls (HC) were recruited in the context of an observational, multisite study (GECOBIP). Subjects were genotyped for three candidate single-nucleotide polymorphisms (SNPs) (5-HTTLPR, COMT rs4680, BDNF rs6265); impulsivity was measured through the Italian version of the Barratt Impulsiveness Scale (BIS-11). A mixed-effects regression model was built, with BIS scores as dependent variables, genotypes of the three polymorphisms as fixed effects, and centers of enrollment as random effect. Compared to HC, scores for all BIS factors were higher among subjects with euthymic BD (adjusted β for Total BIS score: 5.35, p < 0.001). No significant interaction effect was evident between disease status (HC vs. BD) and SNP status for any polymorphism. Considering the whole sample, BDNF Met/Met homozygosis was associated with lower BIS scores across all three factors (adjusted β for Total BIS score: −10.2, p < 0.001). A significant 5-HTTLPR x gender interaction was found for the SS genotype, associated with higher BIS scores in females only (adjusted β for Total BIS score: 12.0, p = 0.001). Finally, COMT polymorphism status was not significantly associated with BIS scores. In conclusion, BD diagnosis did not influence the effect on impulsivity scores for any of the three SNPs considered. Only one SNP—the BDNF rs6265 Met/Met homozygosis—was independently associated with lower impulsivity scores. The 5-HTTLPR SS genotype was associated with higher impulsivity scores in females only. Further studies adopting genome-wide screening in larger samples are needed to define the genetic basis of impulsivity in BD.

Rethinking “aggression” and impulsivity in bipolar disorder: Risk, clinical and brain circuitry features

BackgroundElevated aggression and impulsivity are implicated in Bipolar Disorder (BD); however, relationships between these behavioral constructs have not been clarified, which can lead to misconceptions with negative consequences including stigma and adverse outcomes including suicide. The study aimed to clarify brain-based distinctions between the two constructs and their associations to risk factors, symptoms and suicide thoughts and behaviors. MethodsSelf-rated Brown-Goodwin Aggression (BGA) and Barratt Impulsiveness Scale (BIS) scores were compared between adults with BD (n = 38, 74% female) and healthy controls (HC, n = 29, 64% female). Relationships were examined between BGA and BIS with childhood trauma questionnaire (CTQ), mood, comorbidities, and magnetic resonance imaging gray matter volume (GMV) assessments. ResultsIn BD, BGA and BIS total scores were both elevated and associated with childhood maltreatment (CM), particularly emotional CM, depression, substance use disorders (SUDs) and suicide attempts (SAs). BGA scores were increased by items corresponding to dysregulation of emotional and social behavior and associated with elevated mood states and suicide ideation and GMV decreases in bilateral orbitofrontal cortex and left posterior insula brain regions, previously associated with these behaviors and clinical features. BIS motor impulsiveness scores were associated with GMV decreases in anterior cingulate cortex implicated in mood and behavioral dyscontrol. Limitationsmodest sample size, self-reports ConclusionsThe findings suggest separable brain-based domains of dysfunction in BD of motor impulsiveness versus emotionally dysregulated feelings that are primarily self-directed. Both domains are associated with suicide behavior and modifiable risk factors of CM, depression and SUDs that could be targeted for prevention.

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

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.

A self-report and behavioural assessment of impulsivity in bipolar disorder: Evidence of elevated trait but not behavioural facets

• Trait-impulsivity appears elevated within a predominantly euthymic bipolar sample. • Behavioural impulsivity is not elevated within a predominantly euthymic bipolar sample. • Trait-impulsivity may offer some utility as a predictor of functional outcome. • It is necessary to apply multifaceted investigations of impulsivity.

P.271 Cortical volumetric correlates of childhood trauma, anxiety, and impulsivity in bipolar disorder

P.271 Cortical volumetric correlates of childhood trauma, anxiety, and impulsivity in bipolar disorder

Relationship between impulsivity, comorbid anxiety and neurocognitive functions in bipolar disorder

Objective The aim of the study is to examine the relationship between anxiety and impulsivity and to reveal the correlation of these variables with clinical and sociodemographic features. It is also aimed to investigate the relationship between impulsivity and anxiety with neurocognitive functions in bipolar disorder. Methods The sample of the study comprises of 71 patients with bipolar disorder type I without any comorbidity (BD), 37 patients with anxiety disorder comorbidity with bipolar disorder type I (BDAD), 52 patients with anxiety disorder (AD) and 50 healthy controls (HC). Participants completed Barratt Impulsivity Scale-11, State-Trait Anxiety Inventory 1–2, Panic Disorder Severity Scale (PDSS), brief version of Fear of Negative Evaluation Scale (FNES), Anxiety Sensitivity Index-3 (ASI-3), Trail-Making Test A–B, Digit Span Test, Stroop Test. Results PDSS scores, trait anxiety level, hypomanic and mixed episode numbers explain 26% of attention impulsivity. Gender and ASI-3 social dimensions explain 16% of motor impulsivity. Trait anxiety explains non-planning and total impulsivity at 26 and 24%, respectively. When neurocognitive impairment’s effect was controlled, it was found AD and BDAD groups had higher impulsivity levels than the BD and HC groups. Conclusion Anxiety disorder comorbidity increases impulsivity in bipolar disorder. KEYPOINTS In the presence of anxiety disorder spectrum comorbidity, bipolar disorder patients will have increased impulsivity and the clinical course may be more severe. Trait anxiety levels and anxiety sensitivity may be predictive factors for impulsivity. In the presence of anxiety disorder spectrum comorbidity, it should be taken into consideration that these patients may be more impulsive and should be treated with more care in terms of evaluation of the disorder.

Cortical Volumetric Correlates of Childhood Trauma, Anxiety, and Impulsivity in Bipolar Disorder.

ObjectiveMore recently, attention has turned to the linkage between childhood trauma and emotional dysregulation, but the evidence in bipolar disorder (BD) is limited. To determine neurobiological relationships between childhood trauma, current anxiety, and impulsivity, we investigated cortical volumetric correlates of these clinical factors in BD. MethodsWe studied 36 patients with DSM-5 BD and 29 healthy controls. Childhood trauma, coexisting anxiety, and impulsivity were evaluated with the Korean version-Childhood Trauma Questionnaire (CTQ), the Korean version-Beck Anxiety Inventory (BAI), and the Korean version-Barratt Impulsiveness Scale (BIS). Voxel-based morphometry (VBM) was used to assess gray matter volume (GMV) alterations on the brain magnetic resonance imaging (MRI). Partial correlation analyses were conducted to examine associations between the GMV and each scale in the BD group. ResultsChildhood trauma, anxiety, and impulsivity were interrelated in BD. BD patients revealed significant inverse correlations between the GMV in the right precentral gyrus and CTQ scores (r=-0.609, p<0.0003); between the GMV in the left middle frontal gyrus and BAI scores (r=-0.363, p=0.044). Moreover, patients showed similar tendency of negative correlations between the GMV in the right precentral gyrus and BIS scores; between the GMV in the left middle frontal gyrus and CTQ scores. ConclusionThe present study provides evidence for a neural basis between childhood trauma and affect regulations in BD. The GMV alterations in multiple frontal lobe areas may represent neurobiological markers for anticipating the course of BD.

Is affective lability related to aggression and impulsivity in bipolar disorder? (tur)

Is affective lability related to aggression and impulsivity in bipolar disorder? (tur)

The evening chronotype independently predicts emotion dysregulation and increased impulsivity in bipolar disorder. A pilot study

The evening chronotype independently predicts emotion dysregulation and increased impulsivity in bipolar disorder. A pilot study

Are self-rated and behavioural measures of impulsivity in bipolar disorder mainly related to comorbid substance use problems?

ABSTRACTIntroduction: Impulsivity is a multidimensional feature observed in bipolar disorder (BD) and substance use disorder (SUD). We previously found a relationship between SUD and risk taking in BD. It is still unclear whether self-rated and behavioral impulsivity measures differ between BD with and without comorbid SUD, or are specific to BD.Methods: 93 adults with BD with comorbid SUD, 91 BD without SUD, and 93 healthy controls (HC) were administered the Barratt Impulsivity Scale (BIS), the Behavioral Inhibition/Behavioral Activation System Scale (BIS/BAS), and the Cambridge Neuropsychological Test Automated Battery. Analyses compared impulsivity measures across groups controlling for age. Discriminant function analyses (DFA) assessed the combination of variables effectively predicting group membership.Results: BD displayed increased BIS, BIS/BAS scores, reduced performance on the Cambridge Gambling and Rapid Visual Processing, and Affective Go/No-Go tasks compared to HC. Comparisons between BD with and without SUD showed increased BIS Motor impulsiveness. The overall predictive power of DFA was weak.Conclusions: Some facets of impulsivity are a core trait of BD and are partially independent from the presence of SUD. Motor impulsiveness may be distinctive of BD+SUD. More research is needed to understand the role of impulsive behaviors as risk factors for relapse in SUD.

Behavioral measures and self-report of impulsivity in bipolar disorder: no association between Stroop test and Barratt Impulsiveness Scale.

BackgroundImpulsivity as a tendency to act quickly without considering future consequences has been proposed as a dimensional factor in bipolar disorder. It can be measured using behavioral tasks and self-report questionnaires. Previous findings revealed patients to show worse performance on at least one behavioral measure of impulsivity. Additionally, self-reported impulsivity seems to be higher among bipolar patients, both parameters being possibly associated with a more severe course of illness. In this study, our primary aim was to investigate the relationship between these two constructs of impulsivity among bipolar patients.MethodsA total of 40 euthymic patients with bipolar disorder (21 female, 22 Bipolar I) and 30 healthy controls were recruited for comprehensive neuropsychological assessment. To assess inhibition control as a behavioral measure of impulsivity, the Stroop Color and Word Test (Stroop) was used. Additionally, both groups completed the Barratt Impulsiveness Scale (BIS) as a self-report of impulsivity. To compare the groups’ performance on the Stroop and ratings on the BIS, the non-parametric Mann–Whitney U test was used. Within the bipolar group, we additionally examined the possibility of an association between Stroop performance and BIS total scores using Pearson’s Correlation r.ResultsPatients and controls differed significantly on the Stroop and BIS, with patients performing worse on the Stroop and scoring higher on the BIS. However, there was no association between the Stroop and BIS within the bipolar group. As an exploratory analysis, a positive correlation between Stroop performance and number of episodes was found. Further, we detected a statistical trend in the direction of poorer Stroop performance among patients treated with polypharmacy.ConclusionsBoth difficulties with behavioral inhibition and self-reported impulsivity were observed to be higher in bipolar patients than controls in the current study. However, within the patient group we did not observe an association between patients’ behavioral performance and self-report. This indicates that the parameters likely constitute distinct, dimensional factors of bipolar disorder. In future research, studies with larger samples should investigate which of the two markers constitutes the better marker for the illness and is more suitable to differentiate the most severe patients.

The temporal course and clinical correlates of subjective impulsivity in bipolar disorder as revealed through ecological momentary assessment

BackgroundImpulsivity is frequently linked with bipolar disorder and is associated with mania and negative outcomes. The temporal dynamics of subjective impulsivity are unclear, in particular whether impulsivity precedes or follows changes in positive or negative affect. MethodsA total of 41 outpatients with bipolar disorder (I or II) were provided with mobile devices for 11 weeks and completed twice-daily surveys about affective states and subjective impulsivity. We examined the association between aggregate subjective impulsivity with baseline global cognitive function, suicide risk ratings, and medication adherence, as well as concurrent and lagged associations with momentary positive and negative affect ratings. ResultsA total of 2902 ratings were available across study subjects. Higher aggregate mean ratings of impulsivity were associated with worse baseline global cognitive function, prior suicide attempts, and self-reported problems with medication adherence, as well as more severe manic (but not depressive) symptoms. Time-lagged models indicated that greater negative affect, but not positive affect, predicted subsequent increases in subjective impulsivity, which, in turn, predicted diminished positive affect. LimitationsOther measures of impulsivity with which to validate subjective ratings were unavailable and the sample was restricted to generally clinically stable outpatients. ConclusionsSubjective impulsivity as measured by daily monitoring was associated with worse cognitive function and self-rated medication adherence, and higher suicide risk ratings. Impulsivity may be a maladaptive strategy to regulate negative affect in bipolar disorder.

Comorbid obsessive–compulsive disorder with bipolar disorder: A distinct form?

We examined whether the patients with Bipolar Disorder (BD) and Obsessive–Compulsive Disorder (OCD) comorbidity may represent a distinct form of BD. The subjects diagnosed with BD (n=48), OCD (n=61), and BD with OCD (n=32) were compared in terms of several socio-demographic and clinical characteristics. Previous history of suicidal attempts was more likely to be higher in BD–OCD group compared to the other two groups. A more episodic course of OCD, higher rates of rapid cycling, and the seasonality were found in BD–OCD patients. The frequency of bipolar II and NOS subtypes was more prevalent in patients with BD–OCD than in OCD patients. The first diagnosed illness was BD in the majority of BD–OCD cases. It was found that first affective episode was major depression in half of BD–OCD patients. Age at onset of BD was found to be earlier in BD–OCD group compared to pure BD patients. Bipolarity may not have a specific effect on the phenomenology of OC symptoms. The episodic course of OCD, seasonality, rapid cycling, earlier onset of BD, and impulsivity in BD–OCD patients may be indicative for a distinct form of BD.

Does a history of substance abuse and illness chronicity predict increased impulsivity in bipolar disorder?

BackgroundImpulsivity is a common feature shared by bipolar disorder (BD) and substance use disorder (SUD). SUD and recurrent mood episodes are considered to be risk factors for poor outcome in BD. However, the association between impulsivity, illness chronicity and SUD in BD remains unexplored. Methods103 BD patients with and without a lifetime history of SUD (36.82±11.34 years, 40 males) were recruited. Participants completed the SCID interview and were administered measures of impulsivity including the Barratt Impulsivity Scale (BIS) and selected tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). Hierarchical regression analyses explored the relationship between illness chronicity, SUD, and impulsivity. ResultsVariance in the BIS, number of false alarms on the Rapid Visual Processing task and other impulsivity indicators of the Cambridge Gambling Task (CGT) was not explained by the chosen variables. Only an increased number of commission errors in the negative condition of the Affective Go/No Go task was significantly associated with illness chronicity. Furthermore there was a trend suggesting a relationship between a lifetime history of SUD and increased propensity to risk-taking during the CGT. LimitationsPotential limitations include medication and patients׳ remission status from SUD. ConclusionsContrary to our expectations impulsivity was generally not predicted by indicators of illness chronicity or SUD. While impulsivity could still be a marker of BD that is present before the onset of the disorder, the link between the number of mood episodes and specific indicators of impulsivity may be related to mechanisms of neuroprogression.

Impulsivity in euthymic bipolar disorder patients and relation with age at onset of the disorder

Objective: Bipolar disorder is a serious disease that causes loss of functionality and disability. Impulsivity, which has been defined as making plans and take action without thinking is divided into two components: state impulsivity and trait impulsivity. Although trait impulsivity is the component of impulsivity that remains constant at different episodes of the disorder, state impulsivity is the changing part due to the state of the disorder. In this study we aimed to test the hypothesis that the impulsivity is statistically higher in patients with bipolar disorders than normal controls when the impact of attention deficit hyperactivity disorder was controlled. Method: Fifty-three patients with bipolar disorder were taken to the study. Age and sex matched 52 individuals who had not any history of psychiatric illness lifetime included in the study as a control group. Diagnoses were confirmed by an experienced psychiatrist with using the Structured Clinical Interview for DSM-IV according to the DSM-IV -TR. SKIP-TURK form was used to collect socio demographic data and information associated with the illness. Wender Utah Rating Scale, Barratt Impulsiveness Scale Version 11 (BIS-11) was applied to the patients and the control group. Results: There was no significantly difference between the patients and control groups in terms of Wender Utah rating scales average scores and the ratio of the individuals who had higher scores from the cut-off point. This study, which aimed to show the impulsivity in bipolar disorder is trait, demonstrated that Barratt Impulsiveness Scale Version 11 score was significantly higher in euthymic bipolar disorder patients than the control group. The negative correlation was also found in this study between age at onset and attention, motor, non-planning subscale scores in Barratt Impulsiveness Scale-11. Discussion: Eliminating the effect of impulsivity seen in Attention Deficit Hyperactivity Disorder that often accompanies bipolar disorders, these results indicate that the impulsivity in euthymic bipolar disorder patients is significantly higher than the control group. Determination of the higher impulsivity in euthymic bipolar disorder patients than the control group and the negative correlation between the age at onset and impulsivity levels shows that the impulsivity in bipolar disorder has a trait component in addition to state.