Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder
Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder
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DOI：
10.1176/appi.ajp.162.9.1680
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发表时间：
2005-09-01
影响因子：
17.7
通讯作者：
Moeller, FG
中科院分区：
文献类型：
--
作者：
Swann, AC;Dougherty, DM;Moeller, FG
背景：冲动性是双相情感障碍的一个突出的和可测量的特征，可以导致自杀行为的风险。本研究的目的是探讨双相情感障碍患者的冲动性和过去自杀行为的严重程度之间的关系，这是最终自杀的潜在预测因素。在有明确的自杀未遂史或没有自杀未遂史的双相情感障碍受试者中，冲动性是通过问卷和（Barratt冲动量表）和行为实验室表现测量（即时记忆/延迟记忆任务）。诊断由DSM-IV的结构化临床访谈确定。病人的采访和审查记录被用来确定过去的自杀企图和最严重的attempt.Results的医疗严重程度的数量：与自杀企图的历史的主题有更多的冲动错误的即时记忆任务，并有较短的反应延迟，特别是冲动反应。在医学上最严重的自杀企图中，冲动性最高。在测试时，没有考虑到抑郁或躁狂的存在。Barratt冲动量表评分在有自杀企图的受试者中数值较高，但不显著。酗酒史与自杀企图的可能性更大相关。多变量分析表明，乙醇滥用的历史和临床状态在测试的时候没有显着的影响后，impulsivitywas taken into account.Discussion：这些结果表明，在双相情感障碍患者的严重自杀行为的历史与冲动，表现为一种倾向，迅速，无计划的反应。
Background: Impulsivity is a prominent and measurable characteristic of bipolar disorder that can contribute to risk for suicidal behavior. The purpose of this study was to investigate the relationship between impulsivity and severity of past suicidal behavior, a potential predictor of eventual suicide, in patients with bipolar disorder.Method: In bipolar disorder subjects with either a definite history of attempted suicide or no such history, impulsivity was assessed with both a questionnaire ( Barratt Impulsiveness Scale) and behavioral laboratory performance measures ( immediate memory/delayed memory tasks). Diagnosis was determined with the Structured Clinical Interview for DSM-IV. Interviews of patients and review of records were used to determine the number of past suicide attempts and the medical severity of the most severe attempt.Results: Subjects with a history of suicide attempts had more impulsive errors on the immediate memory task and had shorter response latencies, especially for impulsive responses. Impulsivity was highest in subjects with the most medically severe suicide attempts. Effects were not accounted for by presence of depression or mania at the time of testing. Barratt Impulsiveness Scale scores were numerically, but not significantly, higher in subjects with suicide attempts. A history of alcohol abuse was associated with greater probability of a suicide attempt. Multivariate analysis showed that ethanol abuse history and clinical state at the time of testing did not have a significant effect after impulsivity was taken into account.Discussion: These results suggest that a history of severe suicidal behavior in patients with bipolar disorder is associated with impulsivity, manifested as a tendency toward rapid, unplanned responses.