title: Does a history of substance abuse and illness chronicity predict increased impulsivity in bipolar disorder?
abstract: BACKGROUND
  Impulsivity is a common feature shared by bipolar disorder (BD) and substance use disorder (SUD). SUD and recurrent mood episodes are considered to be risk factors for poor outcome in BD. However, the association between impulsivity, illness chronicity and SUD in BD remains unexplored.
  
  
  METHODS
  103 BD patients with and without a lifetime history of SUD (36.82±11.34 years, 40 males) were recruited. Participants completed the SCID interview and were administered measures of impulsivity including the Barratt Impulsivity Scale (BIS) and selected tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). Hierarchical regression analyses explored the relationship between illness chronicity, SUD, and impulsivity.
  
  
  RESULTS
  Variance in the BIS, number of false alarms on the Rapid Visual Processing task and other impulsivity indicators of the Cambridge Gambling Task (CGT) was not explained by the chosen variables. Only an increased number of commission errors in the negative condition of the Affective Go/No Go task was significantly associated with illness chronicity. Furthermore there was a trend suggesting a relationship between a lifetime history of SUD and increased propensity to risk-taking during the CGT.
  
  
  CONCLUSIONS
  Potential limitations include medication and patients׳ remission status from SUD.
  
  
  CONCLUSIONS
  Contrary to our expectations impulsivity was generally not predicted by indicators of illness chronicity or SUD. While impulsivity could still be a marker of BD that is present before the onset of the disorder, the link between the number of mood episodes and specific indicators of impulsivity may be related to mechanisms of neuroprogression.
authors: University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, 1941 East Road, Houston, TX 77054, United States. Electronic address: Isabelle.E.Bauer@uth.tmc.edu.
authors: Isabelle E
authors: IE
authors: Bauer
authors: University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, 1941 East Road, Houston, TX 77054, United States. Electronic address: Thomas.D.Meyer@uth.tmc.edu.
authors: Thomas D
authors: TD
authors: Meyer
authors: University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, 1941 East Road, Houston, TX 77054, United States.
authors: Marsal
authors: M
authors: Sanches
authors: University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, 1941 East Road, Houston, TX 77054, United States.
authors: Giovana
authors: G
authors: Zunta-Soares
authors: University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, 1941 East Road, Houston, TX 77054, United States.
authors: Jair C
authors: JC
authors: Soares
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology*; D055815:Young Adult
keywords: Bipolar disorder; Illness chronicity; Impulsivity; Substance abuse