Benazzi Franco
University of California at San Diego, CA, USA.
Eur Psychiatry. 2007 Oct;22(7):472-8. doi: 10.1016/j.eurpsy.2007.03.008. Epub 2007 May 22.
In bipolar-II (BP-II) disorder impulsivity (defined as excessive risky activities by DSM-IV-TR) is one of the symptoms of hypomania. It is unclear if impulsivity is also a trait in BP-II.
The aim was to test if impulsivity was also a trait in BP-II.
Consecutive 136 remitted BP-II outpatients (assessed when presenting for depression by a mood disorder specialist psychiatrist using the Structured Clinical Interview for DSM-IV), self-assessed trait impulsivity during follow-ups, using the Personality Questionnaire of the Structured Clinical Interview for DSM-IV Axis II Disorders, in a private practice. Trait mood swings were also self-assessed, using the TEMPS-A. A trait nature of impulsivity in BP-II could be supported by finding (1) a relatively high frequency, (2) association between trait impulsivity and symptoms of past hypomania, especially impulsivity, (3) dose-response relationship between number of past hypomania symptoms and trait impulsivity, and (4) association between trait impulsivity and trait mood swings (a trait feature of BP-II).
Trait impulsivity was present in 41.1% of BP-II. BP-II with, versus BP-II without, trait impulsivity had significantly more males, trait mood swings, past hypomania symptoms (irritable mood, talkativeness, increased goal-directed activity), and excessive risky activities (i.e. state impulsivity), corresponding to an irritable risky overactivity. Past state impulsivity and trait impulsivity were significantly associated. Number of past hypomania symptoms and trait impulsivity were significantly correlated. A dose-response relationship was found between number of past hypomania symptoms and trait impulsivity.
Findings suggest that trait impulsivity may be a feature of BP-II. Limitation of self-assessment of personality traits should be taken into account. Findings may have treatment impacts, as the combination of trait impulsivity and mood swings may facilitate relapses and mixed states, which mood stabilising agents could prevent/delay.
在双相II型（BP-II）障碍中，冲动性（按照《精神疾病诊断与统计手册》第四版修订版定义为过度的冒险行为）是轻躁狂的症状之一。目前尚不清楚冲动性是否也是BP-II型障碍的一种特质。
旨在检验冲动性是否也是BP-II型障碍的一种特质。
连续纳入136例病情缓解的BP-II型门诊患者（由一名心境障碍专科精神科医生在其因抑郁就诊时，使用《精神疾病诊断与统计手册》第四版的结构化临床访谈进行评估），在私人诊所随访期间，使用《精神疾病诊断与统计手册》第四版轴II障碍结构化临床访谈的人格问卷进行自我评估特质冲动性。特质情绪波动也使用TEMPS-A进行自我评估。BP-II型障碍中冲动性的特质性质可通过以下发现得到支持：（1）相对较高的频率；（2）特质冲动性与既往轻躁狂症状之间的关联，尤其是冲动性；（3）既往轻躁狂症状数量与特质冲动性之间的剂量反应关系；（4）特质冲动性与特质情绪波动之间的关联（BP-II型障碍的一种特质特征）。
41.1%的BP-II型患者存在特质冲动性。有特质冲动性的BP-II型患者与无特质冲动性的患者相比，男性更多，特质情绪波动更多，既往有更多的轻躁狂症状（易激惹情绪、健谈、目标导向活动增加）以及过度的冒险行为（即状态冲动性），对应一种易激惹的冒险性活动过度。既往的状态冲动性与特质冲动性显著相关。既往轻躁狂症状数量与特质冲动性显著相关。既往轻躁狂症状数量与特质冲动性之间存在剂量反应关系。
研究结果表明特质冲动性可能是BP-II型障碍的一个特征。应考虑人格特质自我评估的局限性。研究结果可能对治疗有影响，因为特质冲动性和情绪波动的结合可能促进复发和混合状态，而心境稳定剂可以预防/延缓这种情况。
