Departamento de Psicologia da Universidade Federal de Minas Gerais, Avenida Antonio Carlos 6627, Faculdade de Filosofia e Ciências Humanas, Sala 4010, Belo Horizonte, Minas Gerais, Brazil.
J Affect Disord. 2011 Sep;133(1-2):221-6. doi: 10.1016/j.jad.2011.03.051. Epub 2011 May 6.
Suicide behavior is very frequent in Bipolar Disorder (BD) and they are both closely associated with impulsivity. Furthermore they are, impulsivity, BD and suicide behavior, associated with serotonergic function, at least partially, under genetic determinism and somewhat associated with the serotonin transporter gene polymorphism, the 5-HTTLPR. We aimed to assess different impulsivity components in BD sub-grouped by suicidal attempt and healthy controls. We hypothesized that the non-planning/cognitive impulsivity, could be more closely associated with suicidal behavior. We further associated 5-HTTLPR genotypes with neuropsychological results to test the hypothesis that this polymorphism is associated with cognitive impulsivity.
We assessed 95 euthymic bipolar patients sub-grouped by suicidal attempt history in comparison with 94 healthy controls. All subjects underwent a laboratory assessment of impulsivity (Continuous Performance Test and Iowa Gambling Test). Furthermore the genotyping of 5-HTTLPR was performed in all subjects.
We found that bipolar patients are more impulsive than healthy controls in all impulsivity dimensions we studied. Furthermore bipolar patients with a suicide attempt history have a greater cognitive impulsivity when compared to both bipolar patients without such a history as well when compared to healthy controls. No association was found between 5-HTTLPR genotypes and neuropsychological measures of impulsive behavior.
The sample studied can be considered small and a potentially confounding variable - medication status - was not controlled.
A lifetime suicide attempt seems associated with cognitive impulsivity independently of the socio-demographic and clinical variables studied as well with 5-HTTLPR genotype. Further studies in larger samples are necessary.
自杀行为在双相情感障碍（BD）中非常常见，两者都与冲动密切相关。此外，冲动、BD 和自杀行为至少部分与 5-羟色胺转运体基因多态性（5-HTTLPR）的血清素能功能有关，与遗传决定因素有关，并且与 5-HTTLPR 或多或少地与 5-羟色胺转运体基因多态性有关。我们旨在评估 BD 亚组按自杀企图和健康对照组分组的不同冲动成分。我们假设非计划性/认知冲动可能与自杀行为更密切相关。我们进一步将 5-HTTLPR 基因型与神经心理学结果相关联，以检验该多态性与认知冲动相关的假设。
我们评估了 95 名处于稳定期的双相情感障碍患者，根据自杀企图史分为亚组，并与 94 名健康对照组进行比较。所有受试者均接受了冲动性的实验室评估（连续作业测试和爱荷华赌博测试）。此外，所有受试者均进行了 5-HTTLPR 基因分型。
我们发现，与健康对照组相比，所有我们研究的冲动维度中，双相情感障碍患者都更冲动。此外，与没有自杀史的双相情感障碍患者以及健康对照组相比，有自杀史的双相情感障碍患者的认知冲动性更大。5-HTTLPR 基因型与冲动行为的神经心理学测量之间没有发现关联。
研究的样本量可以认为较小，并且存在潜在的混杂变量-用药情况-未得到控制。
一生中的自杀企图似乎与认知冲动有关，独立于研究的社会人口统计学和临床变量，也与 5-HTTLPR 基因型有关。需要在更大的样本中进行进一步的研究。
