The 2nd to 4th digit ratios (2D:4D) in patients with bipolar disorder

The ratio of the index finger to the ring finger (2D:4D) is a reflection of the intrauterine hormonal environment and a lower ratio has been shown to be associated with male gender, impulsive behaviors, substance abuse, and aggression. Bipolar illness is characterized by increased impulsivity and increased rates of co-morbid substance abuse, but the 2D:4D ratios have not been examined in this disorder.

We measured digit length of both hands in subjects with bipolar disorder and age- and gender-matched non-bipolar controls (n = 50 in each group). Diagnosis was confirmed with structured diagnostic interviews (MINI) and all subjects also completed Barratt Impulsivity Scale-version 11.

The patients did not vary significantly from the controls in demographic variables. Subjects with bipolar disorder had a higher right hand 2D:4D ratio compared to controls (0.967 ± .029 vs. 0.953 ± .035, t = 2.18, p = .03). Despite clearly higher measures of impulsivity in the bipolar group, no relationship could be documented between digit ratio and measures of impulsivity in either group. However, the right hand 2D:4D ratios and total impulsivity scores predicted bipolar disorder diagnosis status.

The predominantly white racial composition of the study sample may limit generalizability to other groups. Only three patients were diagnosed with bipolar type 2, limiting the generalizability of the findings to all bipolar disorder types.

The data confirm previous observations of increased measures of impulsivity in euthymic bipolar individuals, and suggest that the mechanism of this increased impulsivity is different than in impulsivity seen in other conditions such as personality disorders.