Kerr-Gaffney Jess, Nuerzati Yahufu, Kopra Emma I, Young Allan H
Psychology, and Neuroscience, Institute of Psychiatry, King's College London, London, UK.
South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK.
Psychol Med. 2024 Oct 14;54(13):1-9. doi: 10.1017/S0033291724001752.
Impulsivity is elevated in psychosis and during mania in bipolar disorder. Studies in unaffected relatives may help establish whether impulsivity is a heritable, state independent endophenotype. The aim of this systematic review and meta-analysis was to examine whether impulsivity is elevated in unaffected relatives of those with bipolar disorder, schizophrenia, and schizoaffective disorder, compared to controls. Databases were systematically searched up until March 2023 for articles reporting data on a behavioral or self-report measure of impulsivity in first-degree relatives and controls. Nineteen studies were included. Behavioral (10 studies, = 0.35, < 0.001) and self-reported impulsivity was significantly elevated in bipolar disorder relatives compared to controls (5 studies, = 0.46, < 0.001), with small effect sizes. Relatives of those with schizophrenia did not show significantly elevated impulsivity compared to controls on behavioral measures (6 studies, = 0.42, = 0.102). There were not enough studies to conduct a meta-analysis on self-report data in schizophrenia relatives or schizoaffective disorder relatives (self-report or behavioral). Study quality was good, however there was moderate to high heterogeneity in behavioral meta-analyses. Results suggest elevated impulsivity may be an endophenotype for bipolar disorder, present in an attenuated state before and after the illness and in at-risk individuals. This trait, amongst other behavioral and psychological indices, could be used to identify those who are at risk of developing bipolar disorder. Future research should refine measurement across studies and establish which components of impulsivity are affected in those at risk of psychotic and bipolar disorders.
冲动性在精神病以及双相情感障碍的躁狂发作期间会升高。对未患病亲属的研究可能有助于确定冲动性是否是一种可遗传的、与状态无关的内表型。本系统评价和荟萃分析的目的是检验与对照组相比，双相情感障碍、精神分裂症和分裂情感性障碍患者的未患病亲属的冲动性是否升高。系统检索数据库至2023年3月，以查找报告一级亲属和对照组冲动性行为或自我报告测量数据的文章。纳入了19项研究。与对照组相比，双相情感障碍亲属的行为冲动性（10项研究，效应量 = 0.35，P < 0.001）和自我报告的冲动性显著升高（5项研究，效应量 = 0.46，P < 0.001），效应量较小。与对照组相比，精神分裂症患者亲属在行为测量上未显示出冲动性显著升高（6项研究，效应量 = 0.42，P = 0.102）。没有足够的研究对精神分裂症亲属或分裂情感性障碍亲属的自我报告数据（自我报告或行为数据）进行荟萃分析。研究质量良好，但行为荟萃分析中存在中度到高度的异质性。结果表明，冲动性升高可能是双相情感障碍的一种内表型，在疾病前后以及高危个体中以减弱的状态存在。这一特征，连同其他行为和心理指标，可用于识别有患双相情感障碍风险的人群。未来的研究应完善各研究中的测量方法，并确定冲动性的哪些成分在有精神病性和双相情感障碍风险的个体中受到影响。
