Mechanisms of impulsivity in bipolar disorder and related illness

2010 ◽  
Vol 19 (2) ◽  
pp. 120-130 ◽  
Author(s):  
Alan C. Swann
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Personality Disorder ◽  
Substance Use Disorders ◽  
Antisocial Personality Disorder ◽  
Suicide Attempts ◽  
Affective State ◽  
Rapid Response ◽  
Antisocial Personality ◽  
Course Of Illness

SummaryAims – Impulsivity is a multifaceted aspect of behavior that is prominent in psychiatric disorders and has serious behavioral consequences. This paper reviews studies integrating behavioral and physiological mechanisms in impulsivity and their role in severity and course of bipolar and related disorders. Methods – This is a review of work that used questionnaire, human behavioral laboratory, and neurophysiological measurements of impulsivity or related aspects of behavior. Subjects included individuals with bipolar disorder, substance-use disorders, antisocial personality disorder, and healthy controls. Results – Models of impulsivity include rapid-response impulsivity, with inability to reflect or to evaluate a stimulus adequately before responding, and reward-based impulsivity, with inability to delay response for a reward. In normal subjects, rapid-response impulsivity is increased by yohimbine, which increases norepinephrine release. Impulsivity is increased in bipolar disorder, whether measured by questionnaire, by measures of rapid-response impulsivity, or by measures of ability to delay reward. While affective state has differential effects on impulsivity, impulsivity is increased in bipolar disorder regardless of affective state or treatment. Impulsivity, especially rapid-response, is more severe with a highly recurrent course of illness or with comorbid substance-use disorder, and with history of medically severe suicide attempt. In antisocial personality disorder, rapid-response impulsivity is increased, but rewardbased impulsivity is not. In general, impulsivity is increased more in bipolar disorder than in antisocial personality disorder. In combined bipolar disorder and antisocial personality disorder, increased impulsivity is associated with substance-use disorders and suicide attempts. Conclusions – Impulsivity is associated with severe behavioral complications of bipolar disorder, antisocial personality disorder, and substance-use disorders.

Reaching Out to Patients with Antisocial Personality Disorder with Brief Psychoeducation

2017 ◽  
Vol 41 (S1) ◽  
pp. S70-S71
Author(s):  
M. Hesse ◽  
B. Thylstrup
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Personality Disorder ◽  
Substance Abuse Treatment ◽  
Substance Use Disorders ◽  
Antisocial Personality Disorder ◽  
Antisocial Personality ◽  
Treatment As Usual ◽  
Abuse Treatment

IntroductionPatients with antisocial personality disorder incur high costs on society, and are at high risk of dropping out of treatment and are often excluded from treatment, yet very little research has been conducted on how to best help these patients.ObjectivesTo test a six-session psychoeducation program, Impulsive Lifestyle Counselling, in outpatients with substance use disorders and antisocial personality disorder.AimsTo test the efficacy of the intervention versus treatment as usual in community outpatient treatment for substance use disorders.MethodsPragmatic randomized trial in 13 outpatient community substance abuse treatment uptake areas. Patients were interviewed by blinded interviewers 3, 9 and 15 months post-randomization and tracked through a national substance abuse treatment register. Mixed effects regression were used to assess substance use and self-reported aggression and Cox regression was used to assess risk of dropout.ResultsA total of 175 patients was randomized. At 3-month follow-up, patients randomized to intervention reported more days abstinent and less drug use severity than patients randomized to treatment as usual. In addition, patients randomized to intervention were at lower risk of dropout after intervention. In addition, patients randomized to intervention were more likely to report having received help for antisocial personality disorder at follow-up interviews.ConclusionsA brief psychoeducational intervention may improve outcomes for outpatients with antisocial personality disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Conduct Disorder and Antisocial Personality Disorder in Persons With Severe Psychiatric and Substance Use Disorders

2005 ◽  
Vol 32 (4) ◽  
pp. 626-636 ◽  
Author(s):  
K. T. Mueser ◽  
A. G. Crocker ◽  
L. B. Frisman ◽  
R. E. Drake ◽  
N. H. Covell ◽  
...  
Keyword(s):  
Substance Use ◽  
Personality Disorder ◽  
Conduct Disorder ◽  
Substance Use Disorders ◽  
Antisocial Personality Disorder ◽  
Antisocial Personality

Associations between psychiatric disorder and offending

2012 ◽  
pp. 1917-1926
Author(s):  
Lindsay Thomson ◽  
Rajan Darjee
Keyword(s):  
Substance Use ◽  
Personality Disorder ◽  
Psychiatric Disorder ◽  
Mental Disorder ◽  
Learning Disability ◽  
Substance Use Disorders ◽  
Antisocial Personality Disorder ◽  
Antisocial Behaviour ◽  
Antisocial Personality ◽  
Violent Offending

The associations between psychiatric disorder and offending are complex. There has been a great deal of research into certain disorders and violent offending particularly over the last two decades. In summary, this has found a clear and consistent association between schizophreniform psychoses and violence, the importance of premorbid antisocial behaviour in predicting future violence, and the adjunctive effect of co-morbid substance misuse and antisocial personality disorder in the prevalence of violence. In addition, it has allowed the development of neuropsychiatric models to begin to explain violence in the context of mental disorder. Substance use disorders and learning disability are discussed in Chapters 11.3.2 and 11.3.3.

Sign in / Sign up

Export Citation Format

Share Document