• B Etain, F Mathieu, S Liquet, A Raust, B Cochet, J R Richard, S Gard, L Zanouy, J P Kahn, R F Cohen, T Bougerol, C Henry, M Leboyer, and F Bellivier.
• Inserm, U955, Créteil 94000, France. bruno.etain@inserm.fr
• J Affect Disord. 2013 Jan 25; 144 (3): 240-7.

BackgroundA strong association has been reported between trait-impulsiveness and bipolar disorder (BD). Much attention has been focused on this association, but subgroup analysis has generated conflicting results, raising questions about the role of trait-impulsiveness in suicidal behavior and substance misuse in bipolar patients.MethodWe compared Barratt Impulsiveness Scale-10 scores between 385 euthymic bipolar patients and 185 healthy controls. We then investigated possible association between impulsiveness scores and the following clinical characteristics: suicide attempt (SA), lifetime alcohol/cannabis misuse, rapid cycling and mixed episodes.ResultsBipolar patients and healthy controls had significantly different BIS-10 total score and subscores (motor, attentional and nonplanning impulsiveness) (all p values <0.0001). No association was observed between BIS-10 total score, personal history of SA, number of SA, age at first SA and history of violent SA. Higher BIS-10 total scores were associated with alcohol misuse (p=0.005), cannabis misuse (p<0.0001), with an additive effect for these two substances (p=0.005). Higher BIS-10 total scores were also associated with rapid cycling (p=0.006) and history of mixed episodes (p=0.002), with an additive effect of these two variables (p=0.0006).LimitationsWe used only one clinical measurement of impulsiveness and did not carry out cognitive assessment.ConclusionThis study demonstrates that trait-impulsiveness may be considered as a dimensional feature associated with BD and with a more severe clinical expression of the disease, characterized by a history of substance misuse, rapid cycling and mixed episodes. We found no association between impulsiveness and SA characteristics in bipolar patients, confirming some previous negative results.Copyright © 2012 Elsevier B.V. All rights reserved.

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