Santana Rachel Primo, Kerr-Gaffney Jess, Ancane Anda, Young Allan H
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AB, UK.
South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
Brain Sci. 2022 Oct 5;12(10):1351. doi: 10.3390/brainsci12101351.
Impulsive behaviour is a key characteristic of mania in bipolar disorder (BD). However, there is mixed evidence as to whether impulsivity is a trait feature of the disorder, present in the euthymic state in the absence of mania. The aim of this systematic review and meta-analysis was to examine whether impulsivity is elevated in euthymic BD in comparison to controls. Electronic databases were searched for papers published until April 2022 reporting data on a self-report or behavioural measure of impulsivity in a euthymic BD group and a healthy control group. In total, 46 studies were identified. Euthymic BD showed significantly higher levels of self-reported impulsivity compared to controls (large effect size). Euthymic BD also showed significantly higher levels of impulsivity on response inhibition and inattention tasks, with moderate and large effect sizes, respectively. Only two studies measured delay of gratification, finding no significant differences between groups. Our results suggest impulsivity may be a trait feature of BD, however longitudinal cohort studies are required to confirm whether elevated impulsivity is present before illness onset. Future research should establish whether cognitive interventions are beneficial in improving impulsivity in BD.
冲动行为是双相情感障碍(BD)躁狂发作的一个关键特征。然而,关于冲动性是否是该疾病的一种特质性特征,即在无躁狂发作的心境正常状态下也存在,相关证据并不一致。本系统评价和荟萃分析的目的是检验与对照组相比,心境正常的双相情感障碍患者的冲动性是否升高。检索了电子数据库,查找截至2022年4月发表的报告心境正常的双相情感障碍组和健康对照组冲动性的自我报告或行为测量数据的论文。共确定了46项研究。与对照组相比,心境正常的双相情感障碍患者自我报告的冲动性水平显著更高(效应量较大)。心境正常的双相情感障碍患者在反应抑制和注意力不集中任务上的冲动性水平也显著更高,效应量分别为中等和较大。只有两项研究测量了延迟满足,未发现两组之间有显著差异。我们的结果表明冲动性可能是双相情感障碍的一种特质性特征,然而需要纵向队列研究来证实冲动性升高是否在疾病发作前就已存在。未来的研究应确定认知干预是否有助于改善双相情感障碍患者的冲动性。
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