Impulse control disorder comorbidity among patients with bipolar I disorder
Impulse control disorder comorbidity among patients with bipolar I disorder
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DOI：
10.1016/j.comppsych.2010.08.004
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发表时间：
2011-07-01
影响因子：
7.3
通讯作者：
Tamam, Lut
中科院分区：
文献类型：
--
作者：
Karakus, Gonca;Tamam, Lut
目的：双相情感障碍患者的冲动性与情绪不稳定、行为问题和无计划行为有关。据报道，在所有类型的情绪发作中，冲动水平都会增加。这种相关性表明冲动控制障碍（ICD）和双相情感障碍之间的高共病率。本研究的目的是比较ICD的患病率和相关的临床和社会人口统计学变量在euthymic双相I patients.Method：共124个连续的双相I患者谁是从我们的双相情感障碍单位的门诊定期参加者招募被列入本研究。所有患者均经对症治疗后缓解。双相情感障碍的诊断是使用精神疾病诊断和统计手册的结构化临床访谈，第四版。冲动控制障碍的调查使用明尼苏达州冲动障碍访谈的修改版本。冲动性用Barratt冲动性量表第11版测量。此外，所有患者完成Zuckerman感觉寻求量表V。结果：在我们的样本中，所有共病ICD的患病率为27.4%（n = 34）。最常见的ICD亚型是病理性皮肤采摘，其次是强迫性购买，间歇性爆发性障碍和震颤性躁狂症。没有纵火狂或强迫性性行为的例子。在年龄、性别、教育水平或婚姻状况方面，双相情感障碍患者的社会人口学特征（有无ICD）无统计学显著差异。ICD（+）组的酒精/物质滥用共病率和自杀未遂次数高于ICD（-）组。ICD（-）组的情绪发作间隔时间长于ICD（+）组。两组之间的情绪发作总数之间存在统计学显著差异，但ICD（+）患者的抑郁发作次数高于ICD（-）患者。首次发病年龄、季节性、精神病特征和疾病慢性化之间无统计学显著差异。ICD（+）组和ICD（-）组在Barratt冲动量表第11版确定的总冲动性、注意力、非计划性和运动冲动性评分方面存在统计学显著差异。结论：根据《精神疾病诊断和统计手册》第四版，文本修订版，的搜索.酒精/物质使用障碍、大量既往自杀企图和抑郁发作应提醒医生双相情感障碍患者中存在可能影响疾病病程和治疗的共病ICD。(C)2011 Elsevier Inc. All rights reserved.
Objective: Impulsivity is associated with mood instability, behavioral problems, and action without planning in patients with bipolar disorder. Increased impulsivity levels are reported at all types of mood episodes. This association suggests a high comorbidity between impulse control disorders (ICDs) and bipolar disorder. The aim of this study is to compare the prevalence of ICDs and associated clinical and sociodemographic variables in euthymic bipolar I patients.Method: A total of 124 consecutive bipolar I patients who were recruited from regular attendees from the outpatient clinic of our Bipolar Disorder Unit were included in the study. All patients were symptomatically in remission. Diagnosis of bipolar disorder was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Impulse control disorders were investigated using the modified version of the Minnesota Impulsive Disorders Interview. Impulsivity was measured with the Barratt Impulsiveness Scale Version 11. Furthermore, all patients completed the Zuckerman Sensation-Seeking Scale Form V.Results: The prevalence rate of all comorbid ICDs in our sample was 27.4% (n = 34). The most common ICD subtype was pathologic skin picking, followed by compulsive buying, intermittent explosive disorder, and trichotillomania. There were no instances of pyromania or compulsive sexual behavior. There was no statistically significant difference between the sociodemographic characteristics of bipolar patients with and without ICDs with regard to age, sex, education level, or marital status. Comorbidity of alcohol/substance abuse and number of suicide attempts were higher in the ICD(+) group than the ICD(-) group. Length of time between mood episodes was higher in the ICD(-) group than the ICD(+) group. There was a statistically significant difference between the total number of mood episodes between the 2 groups, but the number of depressive episodes was higher in the ICD(+) patients as compared with the ICD(-) patients. There was no statistically significant difference between the age of first episode, seasonality, presence of psychotic features, and chronicity of illness. A statistically significant difference was observed between the ICD(+) and ICD(-) groups in terms of total impulsivity, attention, nonplanning, and motor impulsivity scores as determined by the Barratt Impulsiveness Scale Version 11.Conclusion: The present study revealed that there is a high comorbidity rate between bipolar disorder and ICDs based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria. Alcohol/substance use disorders, a high number of previous suicide attempts, and depressive episodes should alert the physician to the presence of comorbid ICDs among bipolar patients that could affect the course and treatment of the disorder. (C) 2011 Elsevier Inc. All rights reserved.