Impulsivity: a link between bipolar disorder and substance abuse

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 (Barra...

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Published inBipolar disorders Vol. 6; no. 3; pp. 204 - 212
Main Authors Swann, Alan C, Dougherty, Donald M, Pazzaglia, Peggy J, Pham, Mary, Moeller, F Gerard
Format Journal Article
LanguageEnglish
Published Oxford, UK Munksgaard International Publishers 01.06.2004
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Abstract 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 non‐bipolar 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.
AbstractList 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 non‐bipolar 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.
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. 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 non-bipolar subjects with and without substance abuse. Secondly, we compared impulsivity in interepisode and manic bipolar subjects with and without substance abuse. 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. 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.
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.BACKGROUNDSubstance 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.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 non-bipolar subjects with and without substance abuse. Secondly, we compared impulsivity in interepisode and manic bipolar subjects with and without substance abuse.METHODSFirst, 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 non-bipolar subjects with and without substance abuse. Secondly, we compared impulsivity in interepisode and manic bipolar subjects with and without substance abuse.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.RESULTSThe 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.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.CONCLUSIONSTrait 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.
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 non‐bipolar 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.
Author Pazzaglia, Peggy J
Moeller, F Gerard
Pham, Mary
Dougherty, Donald M
Swann, Alan C
Author_xml – sequence: 1
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  surname: Swann
  fullname: Swann, Alan C
  organization: Department of Psychiatry and Behavioral Sciences, Mental Sciences Institute, Harris County Psychiatric Hospital, University of Texas Health Science Center, Houston, TX 77030, USA
– sequence: 2
  givenname: Donald M
  surname: Dougherty
  fullname: Dougherty, Donald M
  organization: Department of Psychiatry and Behavioral Sciences, Mental Sciences Institute, Harris County Psychiatric Hospital, University of Texas Health Science Center, Houston, TX 77030, USA
– sequence: 3
  givenname: Peggy J
  surname: Pazzaglia
  fullname: Pazzaglia, Peggy J
  organization: Department of Psychiatry and Behavioral Sciences, Mental Sciences Institute, Harris County Psychiatric Hospital, University of Texas Health Science Center, Houston, TX 77030, USA
– sequence: 4
  givenname: Mary
  surname: Pham
  fullname: Pham, Mary
  organization: Department of Psychiatry and Behavioral Sciences, Mental Sciences Institute, Harris County Psychiatric Hospital, University of Texas Health Science Center, Houston, TX 77030, USA
– sequence: 5
  givenname: F Gerard
  surname: Moeller
  fullname: Moeller, F Gerard
  organization: Department of Psychiatry and Behavioral Sciences, Mental Sciences Institute, Harris County Psychiatric Hospital, University of Texas Health Science Center, Houston, TX 77030, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/15117399$$D View this record in MEDLINE/PubMed
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Brady KT, Lydiard RB. Bipolar affective disorder and substance abuse. J Clin Psychopharmacol 1992; 12: 17s-22s.
Swann AC, Koslow SH, Katz MM et al. Lithium carbonate treatment of mania. Cerebrospinal fluid and urinary monoamine metabolites and treatment outcome. Arch Gen Psychiatry 1987; 44: 345-354.
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Dawes MA, Tarter RE, Kirisci L. Behavioral self-regulation: correlates and 2 years follow-ups for boys at risk for substance abuse. Drug Alcohol Depend 1997; 45: 165-176.
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Strakowski SM, Sax KW, Rosenberg HL, DelBello MP, Adler CM. Human response to repeated low-dose d-amphetamine: evidence for behavioral enhancement and tolerance. Neuropsychopharmacology 2001; 25: 548-554.
Ste
2001; 50
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2001; 21
2003; 130
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2002; 68
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2001; 3
2002; 70
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References_xml – reference: Evenden JL. The pharmacology of impulsive behaviour in rats II. the effects of amphetamine, haloperidol, imipramine, chlordiazepoxide and other drugs on fixed consecutive number schedules (FCN 8 and FCN 32). Psychopharmacology (Berl) 1998; 138: 283-294.
– reference: Kessing LV. The effect of comorbid alcoholism on recurrence in affective disorder: a case register study. J Affect Disord 1999; 53: 49-55.
– reference: Cjte S, Tremblay RE, Nagin D, Zoccolillo M, Vitaro F. The development of impulsivity, fearfulness, and helpfulness during childhood: patterns of consistency and change in the trajectories of boys and girls. J Child Psychol Psychiatry 2002; 43: 609-618.
– reference: Moeller FG, Dougherty DM, Barratt ES, Schmitz JM, Swann AC, Grabowski J. The impact of impulsivity in cocaine use and retention in treatment. J Subst Abuse Treat 2001; 21: 193-198.
– reference: Evenden JL, Ryan CN. The pharmacology of impulsive behaviour in rats: the effects of drugs on response choice with varying delays of reinforcement. Psychopharmacology (Berl) 1996; 128: 161-170.
– reference: Feingold A. Gender differences in personality: a meta-analysis. Psychol Bull 1994; 116: 429-456.
– reference: Moeller FG, Dougherty D, Barratt E et al. Increased impulsivity in cocaine dependent subjects independent of antisocial personality disorder and aggression. Drug Alcohol Depend 2002; 68: 105.
– reference: Dougherty DM, Bjork JM, Marsh DM, Moeller FG. A comparison between adults with conduct disorder and normal controls on a continuous performance test: differences in impulsive response characteristics. Psychological Record 2000; 50: 203-219.
– reference: Barratt ES, Patton JH. In: Hillsdale ZM ed. Impulsivity: Cognitive, Behavioral, and Psychophysiological Correlates in Biological Basis of Sensation-Seeking, Impulsivity, and Anxiety. New Jersey: Lawrence Erlbaum Associates, 1983.
– reference: Dougherty DM, Bjork JM, Moeller FG et al. Familial transmission of continuous performance test behavior: attentional and impulsive response characteristics. J Gen Psychol 2003; 130: 5-21.
– reference: Robinson TE, Berridge KC. The neural basis of drug craving: an incentive-sensitization theory of addiction. Brain Research Reviews 1993; 18: 247-291.
– reference: Grant S, Contoreggi C, London ED. Drug abusers show impaired performance in a laboratory test of decision making. Neuropsychologia 2000; 38: 1180-1187.
– reference: Wilder-Willis KE, Sax KW, Rosenberg HL, Fleck DE, Shear PK, Strakowski SM. Persistent attentional dysfunction in remitted bipolar disorder. Bipolar Disord 2001; 3: 58-62.
– reference: Regier DA, Farm ME, Rae DS. Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) study. JAMA 1990; 264: 2511-2518.
– reference: Cassidy F, Ahearn EP, Carroll BJ. Substance abuse in bipolar disorder. Bipolar Disord 2001; 3: 181-188.
– reference: Anand A, Verhoeff P, Seneca N et al. Brain SPECT imaging of amphetamine-induced dopamine release in euthymic bipolar disorder patients. Am J Psychiatry 2000; 157: 1108-1114.
– reference: Merikangas KR, Mehta RL, Molnar BE et al. Comorbidity of substance use disorders with mood and anxiety disorders: results of the International Consortium in Psychiatric Epidemiology. Addict Behav 1998; 23: 893-907.
– reference: Bartzokis G, Lu PH, Beckson M et al. Abstinence from cocaine reduces high-risk responses on a gambling task. Neuropsychopharmacology 2000; 22: 102-103.
– reference: Brady KT, Lydiard RB. Bipolar affective disorder and substance abuse. J Clin Psychopharmacol 1992; 12: 17s-22s.
– reference: Stanford MS, Barratt ES. Impulsivity and the multi-impulsive personality disorder. Pers Individ Diff 1992; 13: 831-834.
– reference: Swann AC, Bjork JM, Moeller FG, Dougherty DM. Two models of impulsivity: relationship to personality traits and psychopathology. Biol Psychiatry 2002; 51: 988-994.
– reference: Feinman JA, Dunner DL. The effect of alcohol and substance abuse on the course of bipolar affective disorder. J Affective Disord 1996; 37: 43-49.
– reference: Strakowski SM, Sax KW, McElroy SL, Keck PE Jr, Hawkins JM, West SA. Course of psychiatric and substance abuse syndromes co-occurring with bipolar disorder after a first psychiatric hospitalization. J Clin Psychiatry 1998; 59: 465-471.
– reference: Quintin P, Benkelfat C, Launay JM et al. Clinical and neurochemical effect of acute tryptophan depletion in unaffected relatives of patients with bipolar affective disorder. Biol Psychiatry 2001; 50: 184-190.
– reference: Dougherty DM, Bjork JM, Harper RA et al. Behavioral impulsivity paradigms: a comparison in hospitalized adolescents with disruptive behavior disorders. J Child Psychol Psychiatry 2003; 44: 1145-1157.
– reference: Dalton EJ, Cate-Carter TD, Mundo E, Parikh SV, Kennedy JL. Suicide risk in bipolar patients: the role of co-morbid substance use disorders. Bipolar Disord 2003; 5: 58-61.
– reference: Dougherty DM, Moeller FG, Steinberg JL, Marsh DM, Hines SE, Bjork JM. Alcohol increases commission error rates for a continuous performance test. Alcohol Clin Exp Res 1999; 23: 1342-1351.
– reference: Strakowski SM, McElroy SL, Keck PE Jr, West SA. The effects of antecedent substance abuse on the development of first-episode psychotic mania. J Psychiatr Res 1996; 30: 59-68.
– reference: Swann AC, Pazzaglia P, Nicholls A, Dougherty DM, Moeller FG. Impulsivity and phase of illness in bipolar disorder. J Affect Disord 2003; 73: 105-111.
– reference: Isometsa ET, Henriksson MM, Aro HM, Lonnqvist JK. Suicide in bipolar disorder in Finland. Am J Psychiatry 1994; 151: 1020-1024.
– reference: Dawes MA, Tarter RE, Kirisci L. Behavioral self-regulation: correlates and 2 years follow-ups for boys at risk for substance abuse. Drug Alcohol Depend 1997; 45: 165-176.
– reference: Comings DE, Blum K. Reward deficiency syndrome: genetic aspects of behavioral disorders. Prog Brain Res 2000; 126: 325-341.
– reference: Jentsch JD, Taylor JR. Impulsivity resulting from frontostriatal dysfunction in drug abuse: implications for the control of behavior by reward-related stimuli. Psychopharmacology (Berl) 1999; 146: 373-390.
– reference: Burke KC, Burke JD Jr, Regier DA, Rae DS. Age at onset of selected mental disorders in five community populations. Arch Gen Psychiatry 1990; 47: 511-518.
– reference: Kay JH, Altshuler LL, Ventura J, Mintz J. Prevalence of axis II comorbidity in bipolar patients with and without alcohol use disorders. Ann Clin Psychiatry 1999; 11: 187-195.
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SSID ssj0016205
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Snippet Background:  Substance abuse is present in most patients with bipolar disorder and associated with poor treatment outcome and increased risk of suicide....
Background:  Substance abuse is present in most patients with bipolar disorder and associated with poor treatment outcome and increased risk of suicide....
Substance abuse is present in most patients with bipolar disorder and associated with poor treatment outcome and increased risk of suicide. Increased...
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wiley
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StartPage 204
SubjectTerms Adult
alcoholism
bipolar disorder
continuous performance test
Disruptive, Impulse Control, and Conduct Disorders - epidemiology
Female
Humans
impulsivity
Male
mania
substance abuse
Substance-Related Disorders - epidemiology
Surveys and Questionnaires
Title Impulsivity: a link between bipolar disorder and substance abuse
URI https://api.istex.fr/ark:/67375/WNG-PVBN06SV-T/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1399-5618.2004.00110.x
https://www.ncbi.nlm.nih.gov/pubmed/15117399
https://www.proquest.com/docview/71888973
Volume 6
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