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International Journal of Bipolar Disorders

, 4:16

First Online: 17 August 2016Received: 15 June 2016Accepted: 06 August 2016


BackgroundImpulsivity as a tendency to act quickly without considering future consequences has been proposed as a dimensional factor in bipolar disorder. It can be measured using behavioral tasks and self-report questionnaires. Previous findings revealed patients to show worse performance on at least one behavioral measure of impulsivity. Additionally, self-reported impulsivity seems to be higher among bipolar patients, both parameters being possibly associated with a more severe course of illness. In this study, our primary aim was to investigate the relationship between these two constructs of impulsivity among bipolar patients.

MethodsA total of 40 euthymic patients with bipolar disorder 21 female, 22 Bipolar I and 30 healthy controls were recruited for comprehensive neuropsychological assessment. To assess inhibition control as a behavioral measure of impulsivity, the Stroop Color and Word Test Stroop was used. Additionally, both groups completed the Barratt Impulsiveness Scale BIS as a self-report of impulsivity. To compare the groups’ performance on the Stroop and ratings on the BIS, the non-parametric Mann–Whitney U test was used. Within the bipolar group, we additionally examined the possibility of an association between Stroop performance and BIS total scores using Pearson’s Correlation r.

ResultsPatients and controls differed significantly on the Stroop and BIS, with patients performing worse on the Stroop and scoring higher on the BIS. However, there was no association between the Stroop and BIS within the bipolar group. As an exploratory analysis, a positive correlation between Stroop performance and number of episodes was found. Further, we detected a statistical trend in the direction of poorer Stroop performance among patients treated with polypharmacy.

ConclusionsBoth difficulties with behavioral inhibition and self-reported impulsivity were observed to be higher in bipolar patients than controls in the current study. However, within the patient group we did not observe an association between patients’ behavioral performance and self-report. This indicates that the parameters likely constitute distinct, dimensional factors of bipolar disorder. In future research, studies with larger samples should investigate which of the two markers constitutes the better marker for the illness and is more suitable to differentiate the most severe patients.

KeywordsBipolar disorder Impulsivity Inhibition Stroop test Barratt Impulsiveness Scale Euthymic AbbreviationsBDIBeck Depression Inventory

BISBarratt Impulsiveness Scale

FASTFunctional Assessment Short Test

HAMD-21Hamilton Depression Rating Scale version 21

M.I.N.I.Mini-International Neuropsychiatric Interview

StroopStroop Color and Word Test

YMRSYoung Mania Rating Scale

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Autor: Elisa Sophie Strasser - Paula Haffner - Jana Fiebig - Esther Quinlivan - Mazda Adli - Thomas Josef Stamm


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