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情绪障碍患者的特质冲动性。

Trait impulsivity in patients with mood disorders.

作者信息

Peluso M A M, Hatch J P, Glahn D C, Monkul E S, Sanches M, Najt P, Bowden C L, Barratt E S, Soares J C

机构信息

Department of Psychiatry, The University of Texas Health Science Center at San Antonio, USA.

出版信息

J Affect Disord. 2007 Jun;100(1-3):227-31. doi: 10.1016/j.jad.2006.09.037. Epub 2006 Nov 9.

Abstract

BACKGROUND

Impulsivity is a key component of the manic behavior of bipolar disorder and is reported to occur in bipolar patients as a stable characteristic, i.e. a trait. Nevertheless, impulsivity has not been widely studied in depressed bipolar patients. We assessed impulsivity in depressed and euthymic bipolar and unipolar patients and healthy controls. We hypothesized that bipolar subjects would have higher levels of trait impulsivity than the comparison groups.

METHODS

Twenty-four depressed bipolar, 24 depressed unipolar, 12 euthymic bipolar, and 10 euthymic unipolar patients, as well as 51 healthy subjects were evaluated with the Barratt Impulsiveness Scale (BIS). Analysis of covariance with age and sex as covariates was used to compare mean group differences.

RESULTS

Depressed bipolar, euthymic bipolar, and depressed unipolar patients did not differ, and showed greater impulsivity than healthy controls on all of the BIS scales. Euthymic unipolar patients scored higher than healthy controls only on motor impulsivity.

LIMITATIONS

Higher number of past substance abusers in the bipolar groups, and no control for anxiety and personality disorders, as well as small sample sizes, limit the reach of this study.

CONCLUSIONS

This study replicates prior findings of stable trait impulsivity in bipolar disorder patients, and extends them, confirming that this trait can be demonstrated in depressed patients, as well as manic and euthymic ones. Trait impulsivity may be the result of repeated mood episodes or be present prior to their onset, either way it would influence the clinical presentation of bipolar disorder.

摘要

背景

冲动性是双相情感障碍躁狂行为的关键组成部分,据报道在双相情感障碍患者中是一种稳定的特征,即一种特质。然而,冲动性在抑郁发作的双相情感障碍患者中尚未得到广泛研究。我们评估了抑郁发作和心境正常的双相情感障碍及单相情感障碍患者以及健康对照者的冲动性。我们假设双相情感障碍患者的特质冲动性水平会高于对照组。

方法

使用巴雷特冲动性量表(BIS)对24名抑郁发作的双相情感障碍患者、24名抑郁发作的单相情感障碍患者、12名心境正常的双相情感障碍患者、10名心境正常的单相情感障碍患者以及51名健康受试者进行评估。以年龄和性别作为协变量进行协方差分析,以比较各组均值差异。

结果

抑郁发作的双相情感障碍患者、心境正常的双相情感障碍患者和抑郁发作的单相情感障碍患者之间无差异,且在所有BIS量表上均比健康对照者表现出更高的冲动性。心境正常的单相情感障碍患者仅在运动冲动性方面得分高于健康对照者。

局限性

双相情感障碍组中既往药物滥用者数量较多,且未对焦虑和人格障碍进行控制,以及样本量较小,限制了本研究的范围。

结论

本研究重复了先前关于双相情感障碍患者稳定特质冲动性的研究结果,并进行了扩展,证实这种特质在抑郁发作患者以及躁狂发作和心境正常的患者中均可表现出来。特质冲动性可能是反复情绪发作的结果,也可能在发作之前就已存在,无论哪种情况,它都会影响双相情感障碍的临床表现。

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