Nanda Pranav, Tandon Neeraj, Mathew Ian T, Padmanabhan Jaya L, Clementz Brett A, Pearlson Godfrey D, Sweeney John A, Tamminga Carol A, Keshavan Matcheri S
College of Physicians & Surgeons, Columbia University Medical Center, New York, NY, USA.
Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Baylor College of Medicine, Texas Medical Center, Houston, TX, USA.
Schizophr Res. 2016 Jan;170(1):80-6. doi: 10.1016/j.schres.2015.11.030. Epub 2015 Dec 23.
Patients with psychotic disorders appear to exhibit greater impulsivity-related behaviors relative to healthy controls. However, the neural underpinning of this impulsivity remains uncertain. Furthermore, it remains unclear how impulsivity might differ or be conserved between psychotic disorder diagnoses in mechanism and manifestation. In this study, self-reported impulsivity, measured by Barratt Impulsiveness Scale (BIS), was compared between 305 controls (HC), 139 patients with schizophrenia (SZ), 100 with schizoaffective disorder (SZA), and 125 with psychotic bipolar disorder (PBP). In each proband group, impulsivity was associated with regional cortical volumes (using FreeSurfer analysis of T1 MRI scans), suicide attempt history, Global Assessment of Functioning (GAF), and Social Functioning Scale (SFS). BIS scores were found to differ significantly between participant groups, with SZA and PBP exhibiting significantly higher impulsivity than SZ, which exhibited significantly higher impulsivity than HC. BIS scores were significantly related to suicide attempt history, and they were inversely associated with GAF, SFS, and bilateral orbitofrontal cortex (OFC) volume in both SZA and PBP, but not SZ. These findings indicate that psychotic disorders, particularly those with prominent affective symptoms, are characterized by elevated self-reported impulsivity measures. Impulsivity's correlations with suicide attempt history, GAF, and SFS suggest that impulsivity may be a mediator of clinical outcome. The observed impulsivity-OFC correlations corroborate the importance of OFC deficits in impulsivity. These correlations' presence in SZA and PBP but not in SZ suggests that impulsivity may have different underlying mechanisms in affective and non-affective psychotic disorders.
与健康对照组相比，患有精神障碍的患者似乎表现出更多与冲动相关的行为。然而，这种冲动的神经基础仍不确定。此外，在精神障碍诊断之间，冲动在机制和表现上如何不同或保持一致仍不清楚。在本研究中，通过巴拉特冲动性量表（BIS）测量的自我报告冲动性，在305名对照组（HC）、139名精神分裂症患者（SZ）、100名分裂情感性障碍患者（SZA）和125名精神病性双相情感障碍患者（PBP）之间进行了比较。在每个先证者组中，冲动性与区域皮质体积（使用T1 MRI扫描的FreeSurfer分析）、自杀未遂史、功能总体评定量表（GAF）和社会功能量表（SFS）相关。发现参与者组之间的BIS评分存在显著差异，SZA和PBP表现出比SZ显著更高的冲动性，而SZ表现出比HC显著更高的冲动性。BIS评分与自杀未遂史显著相关，并且在SZA和PBP中与GAF、SFS以及双侧眶额皮质（OFC）体积呈负相关，但在SZ中并非如此。这些发现表明，精神障碍，特别是那些具有突出情感症状的精神障碍，其特征是自我报告的冲动性测量值升高。冲动性与自杀未遂史、GAF和SFS的相关性表明，冲动性可能是临床结果的一个中介因素。观察到的冲动性与OFC的相关性证实了OFC缺陷在冲动性中的重要性。这些相关性在SZA和PBP中存在而在SZ中不存在，这表明冲动性在情感性和非情感性精神障碍中可能具有不同的潜在机制。
