Understanding impulsivity in severe depression? A psychometrical contribution.
BACKGROUND
Depression, especially severe depression, is strongly associated with suicidality. Impulsivity is one of the main dimensions of suicidality. The objective of this study was to assess the structure of impulsivity in severe depression and its relationships to suicide attempts.


METHODS
127 depressed in-patients were assessed at admission and after 4 weeks of treatment for depression and impulsivity with the Impulsivity Rating Scale (IRS) and the Impulse Control Scale (ICS) or the Baratt Impulsivity Scale (BIS).


RESULTS
Three dimensions of impulsivity were evidenced in these severely depressed patients, i.e., behavioral loss of control, nonplanning and cognitive. These three dimensions are state dependent. Recent suicide attempts in severe depression are related to loss of control and cognitive impulsivity but not to nonplanning. IRS ad ICS may assess primarily behavioral impulsivity, i.e., loss of control and nonplanning, whereas BIS may assess primarily cognitive impulsivity.


CONCLUSIONS
In the future, these three dimensions should be correlated to biological and genetic markers of impulsivity [serotonergic (5-HT) system] and prospective studies should assess the predictive value of the three dimensions of impulsivity in the occurrence of suicide attempts in depressed patients.
Corruble
Emmanuelle
E
Department of Psychiatry, Bicêtre Hospital, Assistance Publique Hôpitaux de Paris, UPRES PSIGIM, Paris XI University, 78, avenue du General Leclerc, 94230 Le Kremlin Bicêtre, France. emmanuelle.corruble@bct.ap-hop-paris.fr
Benyamina
Amine
A
Bayle
Franck
F
Falissard
Bruno
B
Hardy
Patrick
P
D000328:Adult; D016009:Chi-Square Distribution; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011594:Psychometrics; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*