Interactions between bipolar disorder and antisocial personality disorder in trait impulsivity and severity of illness.
OBJECTIVE
We investigated trait impulsivity in bipolar disorder and antisocial personality disorder (ASPD) with respect to severity and course of illness.


METHODS
Subjects included 78 controls, 34 ASPD, 61 bipolar disorder without Axis II disorder, and 24 bipolar disorder with ASPD, by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (SCID-I and -II). Data were analyzed using general linear model and probit analysis.


RESULTS
Barratt Impulsiveness Scale (BIS-11) scores were higher in ASPD (effect sizes 0.5-0.8) or bipolar disorder (effect size 1.45) than in controls. Subjects with both had more suicide attempts and previous episodes than bipolar disorder alone, and more substance-use disorders and suicide attempts than ASPD alone. BIS-11 scores were not related to severity of crimes.


CONCLUSIONS
Impulsivity was higher in bipolar disorder with or without ASPD than in ASPD alone, and higher in ASPD than in controls. Adverse effects of bipolar disorder in ASPD, but not of ASPD in bipolar disorder, were accounted for by increased impulsivity.
Swann
A C
AC
Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center, Houston, TX 77030, USA. alan.c.swann@uth.tmc.edu
Lijffijt
M
M
Lane
S D
SD
Steinberg
J L
JL
Moeller
F G
FG
D000328:Adult; D000987:Antisocial Personality Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D035841:Behavioral Research; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis / Q000523:psychology; D007406:Interview, Psychological; D008297:Male; D008499:Medical Records; D015233:Models, Statistical; D009483:Neuropsychological Tests; D010552:Personality Assessment; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012008:Recurrence; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology
D011619:Psychotropic Drugs