Impulsivity: a link between bipolar disorder and substance abuse
Impulsivity: a link between bipolar disorder and substance abuse
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DOI：
10.1111/j.1399-5618.2004.00110.x
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发表时间：
2004-06-01
影响因子：
5.4
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。大多数双相情感障碍患者都存在药物滥用现象，并与治疗结果不佳和自杀风险增加相关。冲动性增加可能是双相情感障碍和药物滥用之间的联系。方法：首先，我们将冲动性作为稳定特征（巴勒特冲动量表，BIS）和状态依赖的行为实验室表现（即时记忆延迟记忆任务，源自连续表现任务）在有或没有药物滥用的双相情感障碍和非双相情感障碍受试者中进行比较。其次，我们比较了有或没有药物滥用的发作间期双相情感障碍受试者和躁狂双相情感障碍受试者的冲动性。结果：发作间期双相情感障碍和有药物滥用史的受试者的 BIS 评分有所增加，并且在有药物滥用的发作间期双相情感障碍受试者中进一步增加。滥用药物的受试者的表现冲动会增加，无论他们是否患有双相情感障碍。在双相情感障碍受试者中，校正年龄后，药物滥用者的 BIS 评分有所增加。与发作间期受试者相比，无论是否有药物滥用史，躁狂症患者的表现冲动性均有所增加，并且与没有药物滥用的躁狂受试者类似，有药物滥用史的发作间期受试者表现冲动性也有所增加。这些差异不能用年龄、性别或病程来解释。结论：双相情感障碍和药物滥用的特质冲动性会增加。仅当存在药物滥用史时，发作间期双相情感障碍的表现冲动才会增加。在不躁狂的情况下，这种冲动倾向的增加可能会导致治疗结果和依从性下降，并增加双相情感障碍伴药物滥用的自杀和攻击风险。
Background. Substance abuse is present in most patients with bipolar disorder and associated with poor treatment outcome and increased risk Of Suicide. Increased impulsivity may be a link between bipolar disorder and substance abuse.Methods: First, we compared impulsivity as a stable trait (Barratt Impulsiveness Scale, BIS) and as state-dependent behavioral laboratory performance (immediate Memory-Delayed Memory task, derived from the Continuous Performance Task) in interepisode bipolar and nonbipolar subjects with and without substance abuse. Secondly, we compared impulsivity in interepisode and manic bipolar Subjects with and without substance abuse.Results: The BIS scores were increased in interepisode bipolar disorder and in subjects with histories of substance abuse, and were increased further in interepisode bipolar Subjects with substance abuse. Performance impulsivity was increased in subjects with substance abuse, regardless of whether they had bipolar disorder. Among Subjects with bipolar disorder, after correction for age, BIS scores were increased in those with substance abuse. Performance impulsivity was increased in manic compared with interepisode subjects, regardless Of Substance abuse history, and was increased in interepisode subjects with Substance abuse similarly to manic Subjects without substance abuse. These differences could not be accounted for by age., gender, or course of illness.Conclusions: Trait impulsivity is increased additively in bipolar disorder and substance abuse. Performance impulsivity is increased in interepisode bipolar disorder only if a history of substance abuse is present. This increased predisposition to impulsivity when not manic may contribute to the decrement in treatment outcome and compliance, and increased risk for suicide and aggression, in bipolar disorder with substance abuse.