Impulsivity a Key Characteristic of Bipolar Disorder. ('Sine Qua Non for Mania')

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MADRID -- Impulsivity is a core component of bipolar disorder that distinguishes patients from control populations, even between episodes, Dr. Alan Swann said at the World Psychiatric Association International Congress 200].

A better understanding of the differences and interactions between trait land state impulsivity could be useful in reducing the ris of dangerous behaviors, including suicide, in bipolar patients and others, said Dr. Swann of the University of Texas, Houston.

A recent trend in psychiatric has been the attempt to go beyond categorical thining and to identify core behavioral elements that underlie disturbances in diverse psychiatric disorders. "These a e basic things the brain does that, if not done properly result in the manifestations of illness," he said.

Impulsivity appears to be an important dimension of several conditions, including bipolar, attention-deficit, substance use, and cluster B personality disorders. It is both a state variable--a measurable aspect of behavior that varies over time--and a stable personality trait. The difference is particularly important to eep in mind in bipolar disorder.

"Impulsivity is the sine qua non for mania," Dr. Swann said. A study of 179 patients found it to be the only factor that was elevated in all inds of manic episodes--depressive, delusional, classic, and irritable. Other factors (hyperactivity, anxious pessimism, distressed appearance, hostility, and psychosis) varied from one type of mania to another.

Studies comparing bipolar patients and normal controls have found that bipolar patients were more impulsive than controls--even when the bipolar patients were euthymic. …