Impulsivity in mood disorders: the role of anxiety and substance use comorbidity
Notice bibliographique
Résumé
Background: Major depressive disorder (MDD) and bipolar disorder (BP) are debilitating mood disorders that are associated with both long-term economic costs and functional impairment. Impulsivity has been implicated in mood disorders, and primarily in BP. Impulsivity is strongly associated with aggression, risk of suicidal behaviour, and overall functional impairment in mood disorders. Studies have found that BP individuals have significantly higher levels of impulsivity than controls, although fewer studies have examined the specific link between impulsivity and BP compared to MDD. Furthermore, there has been very little research pertaining to the differentiation between levels of impulsivity in BP subtypes, including bipolar type I (BPI) and bipolar type II (BPII). As well, impulsivity has been linked with other psychiatric comorbidities, including anxiety disorders as well as substance use disorders (SUDs). However, the role of impulsivity in mood disorders with anxiety disorder or SUD comorbidity has not been established. Objectives: There are two objectives for this study. The first objective is to compare a) MDD and BP subjects and b) MDD, BPI, and BPII subjects on impulsivity, specifically total impulsivity as well as each of the three dimensions of impulsivity: attentional impulsivity, motor impulsivity, and nonplanning impulsivity. The second objective is to examine if comorbid lifetime (a) anxiety disorders or (b) SUDs modify the association between mood disorder (BP and MDD) and impulsivity, specifically total impulsivity as well as each of the three dimensions of impulsivity. Methods: 115 euthymic outpatients with a primary DSM-IV diagnosis of MDD (N=45), BPI (N=53), or BPII (N=17) from the Mood Disorders Program of the McGill University Health Centre were recruited. The Structured Clinical Interview for DSM-IV (SCID) was conducted to diagnose psychiatric disorders. Impulsivity was measured using the self-report questionnaire - Barratt Impulsiveness Scale (BIS-11) - which assesses three dimensions of impulsivity: attentional, motor, and nonplanning impulsivity. A medical chart review was conducted to obtain socio-demographic and psychiatric disorder information. Results: BP subjects had significantly higher total impulsivity as well as motor and nonplanning impulsivity compared to MDD subjects. With regards to specific BP subtypes, BPI subjects had significantly higher total impulsivity and motor impulsivity than MDD subjects, and BPII subjects had significantly higher total impulsivity, as well as attentional, motor, and nonplanning impulsivity than MDD subjects. Finally, BPII subjects had significantly higher attentional impulsivity than BPI subjects. With regards to lifetime psychiatric comorbidity, mood disorder subjects with anxiety disorders had higher levels of attentional impulsivity. For lifetime SUD diagnosis, SUD comorbidity was associated with higher levels of total impulsivity as well as motor and nonplanning impulsivity in mood disorder subjects. There was no interaction between anxiety or SUD comorbidity and mood diagnosis on total or dimensional impulsivity. Conclusions: Impulsivity is an important factor in the clinical presentation of mood disorders. Our results emphasize the importance of impulsivity primarily in BP, as well as impulsivity in BP individuals with a comorbid anxiety disorder or SUD. Further research measuring impulsivity in BP subtypes with different psychiatric comorbidities (e.g., anxiety disorders, SUDs) would help guide health professionals and clinicians in the assessment of impulsivity and the treatment of impulsive aggression, suicidal behaviours, and other clinical correlates of impulsivity in BP subjects.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».