Impulsivity is associated with blood pressure and waist circumference among adolescents with bipolar disorder.
Cardiovascular risk factors (CVRFs) and impulsivity are common in bipolar disorder (BD), and CVRFs are also linked with impulsivity through a number of mechanisms, both behavioral and biological. This study examines the association between CVRFs and impulsivity in adolescents with BD.



Subjects were 34 adolescents with BD and 35 healthy control (HC) adolescents. CVRFs were based on International Diabetes Federation metabolic syndrome criteria (triglycerides, high-density lipoprotein cholesterol, waist circumference, blood pressure (BP) and glucose). Impulsivity was measured using the computerized Cambridge Gambling Task (CGT). Analyses controlled for age, IQ, lifetime attention deficit hyperactivity disorder, and current antipsychotic use.



Adolescents with BD had higher diastolic BP (73.36 ± 9.57 mmHg vs. 67.91 ± 8.74 mmHg, U = 401.0, p = 0.03), higher triglycerides (1.13 ± 0.60 mmol/L vs. 0.78 ± 0.38 mmol/L, U = 373.5, p = 0.008), and were more likely to meet high-risk criteria for waist circumference (17.6% vs. 2.9%, p = 0.04) vs. HC. Within the BD group, CGT sub-scores were correlated with CVRFs. For example, overall proportion bet was positively correlated with systolic (r = 0.387, p = 0.026) and diastolic (ρ = 0.404, p = 0.020) BP. Quality of decision-making was negatively correlated with systolic BP (ρ = -0.401, p = 0.021) and waist circumference (ρ = -0.534, p = 0.003). Significant interactions were observed, such that BD diagnosis moderates the relationship between both waist circumference and BP with CGT sub-scores.



BP and waist circumference are associated with impulsivity in BD adolescents, but not in HC adolescents. Future studies are warranted to determine temporality and to evaluate whether optimizing CVRFs improves impulsivity among BD adolescents.
Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, ON, M4N 3M5, Canada; University of Toronto, Department of Pharmacology and Toxicology, Toronto, ON, M5R 0A3, Canada.
Melanie R
MR
Naiberg
Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, ON, M4N 3M5, Canada; University of Toronto, Department of Pharmacology and Toxicology, Toronto, ON, M5R 0A3, Canada.
Dwight F
DF
Newton
Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, ON, M4N 3M5, Canada.
Jordan E
JE
Collins
Department of Psychology, Queen's University, Kingston, ON K7L 3N6, Canada; Department of Psychiatry, Queen's University, Kingston, ON K7L 3N6, Canada; Centre for Neuroscience Studies, Queen's University, Kingston, ON K7L 3N6, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Christopher R
CR
Bowie
Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, ON, M4N 3M5, Canada; University of Toronto, Department of Pharmacology and Toxicology, Toronto, ON, M5R 0A3, Canada. Electronic address: benjamin.goldstein@sunnybrook.ca.
Benjamin I
BI
Goldstein
D000293:Adolescent; D000887:Anthroposophy; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D001714:Bipolar Disorder / Q000503:physiopathology* / Q000523:psychology; D001794:Blood Pressure / Q000502:physiology*; D001827:Body Height; D002318:Cardiovascular Diseases / Q000150:complications; D016022:Case-Control Studies; D002648:Child; D003657:Decision Making / Q000502:physiology; D005260:Female; D005717:Games, Experimental; D006801:Humans; D007175:Impulsive Behavior / Q000502:physiology*; D008075:Lipoproteins, HDL; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013223:Statistics as Topic; D014280:Triglycerides; D055105:Waist Circumference / Q000502:physiology*
D008075:Lipoproteins, HDL; D014280:Triglycerides
Adolescents; Bipolar disorder; Cardiovascular; Cognition; Impulsivity