Are self-rated and behavioural measures of impulsivity in bipolar disorder mainly related to comorbid substance use problems?

May 12, 2017Cognitive neuropsychiatry

Are self-reported and observed impulsivity in bipolar disorder mostly linked to substance use problems?

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Abstract

Bipolar disorder (BD) patients with substance use disorder (SUD) exhibited increased motor impulsiveness compared to those without SUD.

Impulsivity in BD is linked to increased scores on self-report measures and reduced performance in cognitive tasks.
Individuals with BD showed higher impulsivity scores compared to healthy controls.
Motor impulsiveness may be a distinguishing characteristic of BD patients with comorbid SUD.
The predictive ability of the analysis assessing group membership was found to be weak.
Certain aspects of impulsivity appear to be inherent to BD, independent of SUD presence.

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INTRODUCTION: Impulsivity is a multidimensional feature observed in bipolar disorder (BD) and substance use disorder (SUD). We previously found a relationship between SUD and risk taking in BD. It is still unclear whether self-rated and behavioral impulsivity measures differ between BD with and without comorbid SUD, or are specific to BD.

METHODS: 93 adults with BD with comorbid SUD, 91 BD without SUD, and 93 healthy controls (HC) were administered the Barratt Impulsivity Scale (BIS), the Behavioral Inhibition/Behavioral Activation System Scale (BIS/BAS), and the Cambridge Neuropsychological Test Automated Battery. Analyses compared impulsivity measures across groups controlling for age. Discriminant function analyses (DFA) assessed the combination of variables effectively predicting group membership.

RESULTS: BD displayed increased BIS, BIS/BAS scores, reduced performance on the Cambridge Gambling and Rapid Visual Processing, and Affective Go/No-Go tasks compared to HC. Comparisons between BD with and without SUD showed increased BIS Motor impulsiveness. The overall predictive power of DFA was weak.

CONCLUSIONS: Some facets of impulsivity are a core trait of BD and are partially independent from the presence of SUD. Motor impulsiveness may be distinctive of BD+SUD. More research is needed to understand the role of impulsive behaviors as risk factors for relapse in SUD.

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Are self-rated and behavioural measures of impulsivity in bipolar disorder mainly related to comorbid substance use problems?

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