Impulsivity in Bipolar Disorder: State or Trait?

Area of Science:

• Psychiatry
• Neuroscience
• Clinical Psychology

Background:

• Impulsive behavior is a hallmark of mania in bipolar disorder (BD).
• Evidence is mixed regarding whether impulsivity is a trait feature of BD, persisting in the euthymic state.
• Understanding trait impulsivity is crucial for identifying potential therapeutic targets in BD.

Purpose of the Study:

• To systematically review and meta-analyze existing research on impulsivity levels in euthymic individuals with BD compared to healthy controls.
• To determine if impulsivity is an enduring characteristic of bipolar disorder.

Main Methods:

• A systematic literature search was conducted on electronic databases up to April 2022.
• Included studies reported self-report or behavioral impulsivity measures in euthymic BD patients and healthy controls.
• Data from 46 identified studies were analyzed using meta-analysis.

Main Results:

• Euthymic individuals with BD exhibited significantly higher self-reported impulsivity compared to controls (large effect size).
• Elevated impulsivity was also observed in BD groups on response inhibition (moderate effect size) and inattention tasks (large effect size).
• No significant differences were found in delay of gratification tasks between groups.

Conclusions:

• The findings suggest that impulsivity may be a trait feature of bipolar disorder.
• Longitudinal studies are needed to confirm if elevated impulsivity predates the onset of BD.
• Future research should explore the efficacy of cognitive interventions for managing impulsivity in BD.