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Impulsivity: a link between bipolar disorder and substance abuse.
Alan C Swann1, Donald M Dougherty, Peggy J Pazzaglia
1Department of Psychiatry and Behavioral Sciences, Mental Sciences Institute, Harris County Psychiatric Hospital, University of Texas Health Science Center, Houston, 77030, USA. alan.c.swann@uth.tmc.edu
Bipolar Disorders
|May 1, 2004
Summary
Trait and performance impulsivity are elevated in individuals with bipolar disorder and substance abuse. This heightened impulsivity, particularly in interepisode states, may worsen outcomes and increase suicide risk.
Area of Science:
- Neuroscience
- Psychiatry
- Behavioral Science
Background:
- Substance abuse is common in bipolar disorder, leading to poor treatment outcomes and increased suicide risk.
- Impulsivity may be a key factor linking bipolar disorder and substance abuse.
Purpose of the Study:
- To compare trait and performance impulsivity in bipolar disorder patients with and without substance abuse.
- To examine impulsivity differences between interepisode and manic bipolar states in relation to substance abuse.
Main Methods:
- Assessed trait impulsivity using the Barratt Impulsiveness Scale (BIS).
- Measured performance impulsivity via a laboratory task (Immediate Memory-Delayed Memory).
- Compared impulsivity levels across bipolar and non-bipolar groups, with and without substance abuse history, and across different bipolar states.
Main Results:
- Trait impulsivity (BIS scores) was additively increased in bipolar disorder and substance abuse, and highest in those with both.
- Performance impulsivity was elevated in substance abuse patients, irrespective of bipolar status.
- In bipolar disorder, performance impulsivity was higher in manic than interepisode states, and in interepisode patients with substance abuse.
Conclusions:
- Trait impulsivity is elevated in bipolar disorder and substance abuse independently and additively.
- Performance impulsivity in interepisode bipolar disorder is significantly increased only when substance abuse is present.
- Elevated impulsivity in bipolar disorder with substance abuse may contribute to poorer treatment adherence, increased aggression, and higher suicide rates.