title: High-risk behaviour in hypomanic states.
abstract: BACKGROUND
  Risk-taking behaviours during hypomanic states are recognised, however the high-risk nature of some behaviours-including the potential for harm to both the individual and others-has not been detailed in the research literature. The current study examines risk-taking behaviours and their consequences (including their potential for impairment) in those with a bipolar II condition.
  
  
  METHODS
  Participants were recruited from the Sydney-based Black Dog Institute Depression Clinic. Diagnostic assignment of bipolar II disorder was based on clinician judgement and formal DSM-IV criteria. Participants completed a series of detailed questions assessing previous risk-taking behaviours during hypomanic states.
  
  
  RESULTS
  The sample comprised a total of 93 participants. Risk-taking behaviours during hypomania included spending significant amounts of money, excessive alcohol or drug use, dangerous driving and endangering sexual activities. Key consequences included interpersonal conflict, substantial financial burden and feelings of guilt, shame and remorse. Despite recognition of the risks and consequences associated with hypomanic behaviours, less than one-fifth of participants agreed that hypomania should be treated because of the associated risks.
  
  
  CONCLUSIONS
  Study limitations included a cross-sectional design, reliance on self-report information, lack of controlling for current mood state, and comprised a tertiary referral sample that may be weighted to more severe cases. Findings may therefore not be generalisable and require replication.
  
  
  CONCLUSIONS
  Risk-taking behaviours during hypomania are common, and often linked with serious consequences. Whilst hypomania is often enjoyed and romanticised by patients-leading to ambivalence around treatment of such states-careful consideration of the impact of risk-taking behaviour is necessary, while the study raises the question as to what is 'impairment' in hypomania. Findings should advance clinical management by identifying those high-risk behaviours that would benefit from pre-emptive weighting in developing individual's wellbeing plans for managing the condition.
authors.affiliation: School of Psychiatry, University of New South Wales, NSW, Australia. k.fletcher@unsw.edu.au
authors.forename: Kathryn
authors.initials: K
authors.lastname: Fletcher
authors.forename: Gordon
authors.initials: G
authors.lastname: Parker
authors.forename: Amelia
authors.initials: A
authors.lastname: Paterson
authors.forename: Howe
authors.initials: H
authors.lastname: Synnott
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology; D001334:Automobile Driving / Q000523:psychology; D001714:Bipolar Disorder / Q000523:psychology*; D003132:Commerce; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D019966:Substance-Related Disorders / Q000523:psychology; D055815:Young Adult
keywords: Behaviour; Bipolar disorder; Hypomania; Risk-taking