Bauer Isabelle E, Diniz Breno Satler, Meyer Thomas D, Teixeira Antonio Lucio, Sanches Marsal, Spiker Danielle, Zunta-Soares Giovana, Soares Jair C
University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, 77054 Houston, TX, United States.
University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, 77054 Houston, TX, United States.
J Affect Disord. 2018 Jan 1;225:585-592. doi: 10.1016/j.jad.2017.08.067. Epub 2017 Aug 31.
Impulsivity is a well-established trait of bipolar disorder (BD) that persists across mood phases. It is, however, still unknown whether, in BD, impulsivity remains stable or varies in intensity over the lifespan. This cross-sectional study compared impulsive behavior in older euthymic BD patients and healthy individuals using a range of self-rating and behavioral measures of impulsivity.
28 BD patients (56.07 ± 4.08 years, 16 women) and 15 healthy controls (HC; 55.1 ± 3.95 years, 6 women) were administered the Barratt Impulsivity Scale (BIS) and selected tasks of the Cambridge Neuropsychological Test Automated Batter (CANTAB) reflecting impulsivity. Multivariate analysis of variance controlled for age compared impulsivity measures across BD and HC.
BD patients displayed poor decision making, risk taking, and increased delay aversion. Other measures of impulsivity such as response inhibition, sustained cognitive control, and BIS scores were, overall, comparable between BD and HC.
These preliminary findings suggest that, in BD, aspects of impulsivity related to reward-based decision making persist into late adulthood. Large scale, longitudinal studies are needed to evaluate the relationship of age to impulsivity over time, and explore the link between impulsivity and illness progression in elderly individuals with BD.
冲动性是双相情感障碍（BD）的一个公认特征，在不同情绪阶段均持续存在。然而，在双相情感障碍中，冲动性在整个生命周期内是保持稳定还是强度会发生变化，目前仍不清楚。这项横断面研究使用一系列冲动性的自评和行为测量方法，比较了老年心境正常的双相情感障碍患者和健康个体的冲动行为。
对28名双相情感障碍患者（年龄56.07±4.08岁，女性16名）和15名健康对照者（HC；年龄55.1±3.95岁，女性6名）进行了巴拉特冲动性量表（BIS）测试，并选择了剑桥神经心理测试自动成套系统（CANTAB）中反映冲动性的任务。通过控制年龄的多变量方差分析比较双相情感障碍患者和健康对照者的冲动性测量结果。
双相情感障碍患者表现出决策能力差、冒险行为以及延迟厌恶增加。总体而言，双相情感障碍患者和健康对照者在其他冲动性测量指标上，如反应抑制、持续认知控制和BIS得分，具有可比性。
这些初步研究结果表明，在双相情感障碍中，与基于奖励的决策相关的冲动性方面会持续到成年晚期。需要进行大规模的纵向研究，以评估年龄与冲动性随时间的关系，并探索双相情感障碍老年患者中冲动性与疾病进展之间的联系。
