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    The Australian and New Zealand journal of psychiatry. 2018 Jun 1. doi: 10.1177/0004867418783062
    Impulsivity predicts illness severity in long-term course of bipolar disorder: A prospective approach.
    Rote J1,  Dingelstadt AM2,  Aigner A3,  Bauer M4,  Fiebig J5,  König B6,  Kunze J7,  Pfeiffer S8,  Pfennig A9,  Quinlivan E10,  Simhandl C11,  Stamm TJ12
    Author information
    11 Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
    21 Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
    33 Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
    42 Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.
    51 Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
    65 Department of Psychiatry and Psychotherapy, Landesklinikum Neunkirchen, Neunkirchen, Austria.
    76 Celenus Klinik Carolabad, Chemnitz, Germany.
    82 Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.
    92 Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.
    101 Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
    117 Bipolar Center Wiener Neustadt, Vienna, Austria.
    121 Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
    Abstract

    BACKGROUND: Bipolar disorder is a common, severe and chronic mental illness. Despite this, predictors of illness severity remain poorly understood. Impulsivity is reported to be associated with bipolar disorder and aggravating comorbidities. This study therefore sought to examine the predictive value of impulsivity for determining illness severity in euthymic bipolar disorder patients.

    METHODS: Baseline trait impulsivity of 120 bipolar euthymic patients (81 bipolar disorder I [68%], 80 female [67%]) and 51 healthy controls was assessed using Barratt Impulsiveness Scale 11. The impact of impulsivity on illness severity (measured with morbidity index) was prospectively tested in 97 patients with sufficient follow-up data (average observation time: 54.4 weeks), using linear regression analysis.

    RESULTS: Barratt Impulsiveness Scale 11 total (β = 0.01; p < 0.01) and in particular Barratt Impulsiveness Scale 11 attentional subscale scores (β = 0.04; p < 0.001) predicted illness severity in bipolar disorder, while controlling for other clinical variables. Only age at onset persisted as an additional, but less influential predictor. Barratt Impulsiveness Scale 11 total scores and Barratt Impulsiveness Scale 11 attentional subscale scores were significantly higher in euthymic patients compared to controls. This was not observed for the motor or non-planning subscale scores.

    LIMITATIONS: The average year-long observation time might not be long enough to account for the chronic course of bipolar disorder.

    CONCLUSION: Trait impulsivity and particularly attentional impulsivity in euthymic bipolar patients can be strong predictors of illness severity in bipolar disorder. Future studies should explore impulsivity as a risk assessment for morbidity and as a therapeutic target in bipolar disorder patients.


    KEYWORDS: Bipolar disorder, impulsivity, morbidity

    Publikations ID: 29969910
    Quelle: öffnen
     
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