title: Behavioral addictions in euthymic patients with bipolar I disorder: a comparison to controls.
abstract: BACKGROUND
  Bipolar disorder may be associated with a hypersensitive behavioral approach system and therefore to increased reward sensitivity. The objective of this study is to explore the interrelationships between bipolar disorder, behavioral addictions, and personality/temperament traits in a group of euthymic outpatients with bipolar I disorder and in a group of comparison subjects.
  
  
  METHODS
  Fifty clinically stable patients and 50 comparison subjects matched for age, sex, and educational level were administered the Temperament and Character Inventory-140 and the Behavioral Addiction Scale.
  
  
  RESULTS
  The patient group scored significantly higher than comparison subjects for two benign behavioral addictions (music, shopping) as well as for smoking. Comparison subjects scored higher on two harmful behavioral addictions (drugs, alcohol). Novelty Seeking was positively correlated with harmful addictions, and Cooperativeness was negatively correlated with harmful addictions, in both groups.
  
  
  CONCLUSIONS
  The hypersensitive behavioral approach system model of bipolar disorder would predict higher levels of various addictions in bipolar patients as compared to controls. In this study, this was true for three behavioral addictions, whereas controls showed higher levels of behavioral addiction to drugs and alcohol. This may be because the patients in this study are stable, have received considerable psychoeducation, and are relatively adherent to their medication recommendations. Temperament and character traits may play roles both as risk and protective factors regarding behavioral addictions.
authors.affiliation: Department of Psychology, Ruppin Academic Center, Emek Hefer, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Sapir
authors.affiliation: Department of Psychology, Ruppin Academic Center, Emek Hefer, Israel.
authors.forename: Ada H
authors.initials: AH
authors.lastname: Zohar
authors.affiliation: Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Yuly
authors.initials: Y
authors.lastname: Bersudsky
authors.affiliation: Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Rh
authors.initials: R
authors.lastname: Belmaker
authors.affiliation: Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Yamima
authors.initials: Y
authors.lastname: Osher
keywords: Behavioral addictions; Behavioral approach system; Bipolar disorder; Temperament