Interactions between bipolar disorder and antisocial personality disorder in trait impulsivity and severity of illness

Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center, Houston, TX 77030, USA.
Acta Psychiatrica Scandinavica (Impact Factor: 5.61). 06/2010; 121(6):453-61. DOI: 10.1111/j.1600-0447.2009.01528.x
Source: PubMed


We investigated trait impulsivity in bipolar disorder and antisocial personality disorder (ASPD) with respect to severity and course of illness.
Subjects included 78 controls, 34 ASPD, 61 bipolar disorder without Axis II disorder, and 24 bipolar disorder with ASPD, by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (SCID-I and -II). Data were analyzed using general linear model and probit analysis.
Barratt Impulsiveness Scale (BIS-11) scores were higher in ASPD (effect sizes 0.5-0.8) or bipolar disorder (effect size 1.45) than in controls. Subjects with both had more suicide attempts and previous episodes than bipolar disorder alone, and more substance-use disorders and suicide attempts than ASPD alone. BIS-11 scores were not related to severity of crimes.
Impulsivity was higher in bipolar disorder with or without ASPD than in ASPD alone, and higher in ASPD than in controls. Adverse effects of bipolar disorder in ASPD, but not of ASPD in bipolar disorder, were accounted for by increased impulsivity.

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    • "Reaction times were slower in bipolar disorder than in controls, unless ASPD was also present (Table 2). We have reported that these subjects were more likely than other subjects with bipolar disorder to have many previous episodes of illness (Swann et al., 2010), and that subjects with many previous episodes had faster reaction times than other subjects with bipolar disorder (Swann et al., 2009b). "
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