Department of Psychiatry and Behavioral Sciences, University of Texas Center of Excellence on Mood Disorders, University of Texas-Houston Medical School, Houston, TX 77054, USA.
Bipolar Disord. 2013 Mar;15(2):223-7. doi: 10.1111/bdi.12034. Epub 2013 Jan 3.
Impulsivity is increased in bipolar and unipolar disorders during episodes and is associated with substance abuse disorders and suicide risk. Impulsivity between episodes predisposes to relapses and poor therapeutic compliance. However, there is little information about impulsivity during euthymia in mood disorders. We sought to investigate trait impulsivity in euthymic bipolar and unipolar disorder patients, comparing them to healthy individuals and unaffected relatives of bipolar disorder patients.
Impulsivity was evaluated by the Barratt Impulsiveness Scale (BIS-11A) in 54 bipolar disorder patients, 25 unipolar disorder patients, 136 healthy volunteers, and 14 unaffected relatives. The BIS-11A mean scores for all four groups were compared through the Games-Howell test for all possible pairwise combinations. Additionally, we compared impulsivity in bipolar and unipolar disorder patients with and without a history of suicide attempt and substance abuse disorder.
Bipolar and unipolar disorder patients scored significantly higher than the healthy controls and unaffected relatives on all measures of the BIS-11A except for attentional impulsivity. On the attentional impulsivity measures there were no differences among the unaffected relatives and the bipolar and unipolar disorder groups, but all three of these groups scored higher than the healthy participant group. There was no difference in impulsivity between bipolar and unipolar disorder subjects with and without suicide attempt. However, impulsivity was higher among bipolar and unipolar disorder subjects with past substance use disorder compared to patients without such a history.
Questionnaire-measured impulsivity appears to be relatively independent of mood state in bipolar and unipolar disorder patients; it remains elevated in euthymia and is higher in individuals with past substance abuse. Elevated attentional and lower non-planning impulsivity in unaffected relatives of bipolar disorder patients distinguished them from healthy participants, suggesting that increased attentional impulsivity may predispose to development of affective disorders, while reduced attentional impulsivity may be protective.
双相和单相障碍在发作期间冲动性增加，并与物质滥用障碍和自杀风险相关。发作之间的冲动性易导致复发和治疗依从性差。然而，关于心境障碍在缓解期的冲动性知之甚少。我们试图调查双相和单相障碍缓解期患者的特质冲动性，将其与健康个体和双相障碍患者无病亲属进行比较。
采用巴瑞特冲动量表（BIS-11A）评估 54 例双相障碍患者、25 例单相障碍患者、136 名健康志愿者和 14 名双相障碍患者无病亲属的冲动性。通过 Games-Howell 检验比较所有四组的 BIS-11A 平均得分，比较所有可能的两两组合。此外，我们比较了有和无自杀未遂及物质滥用障碍史的双相和单相障碍患者的冲动性。
除了注意力冲动性外，双相和单相障碍患者在 BIS-11A 的所有测量中得分均显著高于健康对照组和无病亲属。在注意力冲动性测量中，无病亲属与双相和单相障碍组之间没有差异，但这三组的得分均高于健康组。有和无自杀未遂史的双相和单相障碍患者的冲动性无差异。然而，有过去物质使用障碍史的双相和单相障碍患者的冲动性高于无此病史的患者。
问卷测量的冲动性似乎与双相和单相障碍患者的情绪状态相对独立；在缓解期仍处于较高水平，在过去有物质滥用的患者中更高。双相障碍患者无病亲属的注意力冲动性升高和非计划冲动性降低将其与健康参与者区分开来，这表明注意力冲动性升高可能易患情感障碍，而注意力冲动性降低可能具有保护作用。
