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Impulsivity is the tendency to take quick and rash actions without the ability to assess their consequences, resulting in an increased frequency of risky behaviors. In recent years, it has been indicated that impulsivity is a multidimensional construct with different ways of expression in various mental illnesses. Moreover, personality traits might predispose do different psychiatric diagnoses and impact its course.
Objectives
Because differences in the manifestation of impulsivity can be observed at several levels (e.g., behavioral/motor, cognitive, attention, or emotionally related), we applied several tools to check whether they would allow for the differentiation of unipolar (UD) and bipolar (BD) affective disorders.
Methods
The study used data from 282 patients with affective disorders and 95 healthy controls of both sexes. Among the patients, we distinguished a subgroup diagnosed with UD and BD. We included a homogeneous group of patients in euthymia state at the end of hospitalization due to the last depressive episode. The following tools were used: subdimension novelty seeking (NS) of The Temperament and Character Inventory (TCI) and The Barratt Impulsiveness Scale version 11 (BIS-11) to assess various dimensions of impulsivity. The Coping Orientation to Problems Experienced (COPE) was used to assess the strategy of coping with stress. Statistical analyses were performed in Statistica 13.3 StatSoft, Krakow, Poland.
Results
We observed significant differences in BIS-11 dimensions such as motor (MI) (p=0.0006), nonplanning (NP) (p=0.0249), and the sum of impulsivity (p= 0.0095) between UD and BD patients. We found no significant differences in the intensity of impulsivity measured by the NS subdimension, regardless of the type of affective disorder. In the Spearman rank correlation analysis, the following correlations of novelty seeking were revealed (p>0.05):
NS with BIS-11 MI (rs=0.3877, p=0001), BIS-11 NP (rs=-0.2926, p=0042) and COPE-planning (rs=-0.2552, p=0191) dimensions. Moreover, a unique and strong correlation of NS with COPE - focus on and venting of emotions was revealed in BD patients (rs=0.5402, p=0.0461).
Conclusions
The obtained correlation results confirm the multidimensional nature of impulsivity. The relationship between NS and the motor and nonplanning dimensions comes to the fore. Among the tests used, BIS-11 best differentiated unipolar and bipolar patients.
Introduction: Affective patients, especially depressive, have an increased risk of suicidal behavior. Identifying individuals at increased risk remains a challenge. Among the correlates that may be crucial, the impact of personality is emphasized. Attention is paid to impulsivity, measured by subjective or objective tests.
Objectives
Objectives: Comparative analyses were carried out to capture the differences and relationship between personality dimensions, impulsivity, and the decision-making style and coping with stress strategies in suicide attempters and non-attempters in the course of an affective disorder.
Methods
Methods: Data were obtained from 276 individuals diagnosed with unipolar and bipolar affective disorder, both sexes. The study group was disaggregated into a subgroup of patients with (N=95) and without (N=181) suicide attempts in an individual’s history. The Temperament and Character Inventory (TCI) was used to assess personality dimensions. The Barratt Impulsiveness Scale version 11 (BIS-11) was used to measure impulsivity subjectively, and the Simple Reaction Time (SRT) test and the Continuous Performance Test (CPT) were objective assessment methods. The Coping Orientation to Problems Experienced (COPE) and Iowa Gambling Task (IGT) were applied to investigate coping and decision-making styles. Statistical analyses were performed in Statistica 13.3 StatSoft, Krakow, Poland.
Results
Results: In TCI, significant differences between suicide attempters and non-attempters concerned the following dimensions: harm avoidance (HA) (p=<0.0000), self-directedness (SD) (p=0.0001), and cooperativeness (C) (p=0.0186). In the CPT test, significant differences concerned correctly responded trials (p=0.0179) and Bias response (p=0.0230). In IGT, significant differences occurred in IGT block1_sum (p=0.0496) only (Table 1). We did not observe any significant differences in other tests applied. In the Spearman rank correlation analysis in the group of suicide attempters, the following correlations (p>0.05) with at least moderate strength rs>0.4 were revealed: Novelty seeking (NS), SD, and C correlated with several CPT parameters; Persistence (P) correlated with SRT variables; NS, HA and SD with BIS-11 variables.
Conclusions
Conclusions: Objective computerized tests (SRT; CPT; IGT) did not differentiate suicide attempters and non-attempters more clearly than self-reporting personality inventory TCI. Personality traits correlated with SRT and CPT variables. BIS-11 and COPE parameters did not enable to distinguish suicide attempters and non-attempters in the investigated group. This suggests that tests used complement each other, and using a single tool may be insufficient to indicate patients at increased risk of suicidal behavior.
The catecholamine hypothesis of affective disorders suggests that depression is associated with a functional decrease of catecholamines. There is consistent evidence that COMT gene would be a candidate gene for studies of bipolar disorder.
Methods:
The study was performed on patients with bipolar disorder n=298 (male n=126, female n=172). Control subjects were blood donors n=336 (male n=130, female n=206), who were not psychiatrically assessed. The subgroup of patients with psychotic features not congruent with mood contained n=88 patients, males n=41, females n=47. The subgroup of patients with psychotic features congruent with mood contained n=89 patients, males n=47, females n=42. The subgroup of patients with melancholic depression contained n=197 patients, males n=76, females n= 121. A polymorphism was analysed by PCR-RFLP method.
Results:
There were no differences in the frequency of genotypes, alleles between patients and controls in the whole group (p=0,286 for genotypes, p= 0,652 for alleles). Dividing the patients according to the gender, no differences in the frequency of either genotypes or alleles were found (p=0,298 for genotype males, p=0,456 for genotypes females). We did not find the association in the subgroup of patients with psychotic features congruent (p=0,828 for genotypes, p= 0,866 for alleles), or not congruent with mood (p=0,116 for genotypes, p= 0,673 for alleles) and with the subgroup of patients with depression with melancholic features (p= 0,758 for genotypes, p= 0,849 for alleles).
Conclusion:
Results of our study suggest that the polymorphism of COMT gene is not associated with the susceptibility to bipolar disorder.
Working memory and executive functions, connected with the activity of prefrontal cortex play an important role in complex mental processes. Wisconsin Card Sorting Test (WCST) is a main tool used for neuropsychological assessment of prefrontal cortex activity. Molecular genetics studies show the association between the performance on WCST and polymorphism of dopaminergic system genes in schizophrenia and healthy subjects, also with polymorphism of BDNF gene in bipolar disorders.
In this study an association between performance on WCST and polymorphisms of selected candidate genes was assessed.
Methods:
The study included 200 healthy volunteers aged 18-60 years. Neuropsychological assessment was performed using WCST and following domains were evaluated: perseverative errors (inability to change the reaction), nonperseverative errors (attentional inability to avoid distraction), number of completed categories (ability to utilize new information), percent of conceptual responses (ability of conceptual thinking) and set to complete 1st category (ability to formulate a logical conception). Genotyping were done for polymorphism of dopaminergic: D1receptor (-48A/G) and catechol-O-methyltransferase (COMT108/158Val/Met), serotoninergic (5-HTTLPR), glutamatergic: FYNkinase (93A/G, IVS10+37T/C, Ex12+894T/G) and neurotrophic: brain-derived neurotrophic factor (BDNF:C-270T,Val66Met) genes.
Results:
A/G polymorphism of DRD1 gene was connected with better results on trials to complete 1st category. Better performance on nonperseverative errors was observed in females with Val/Val genotype of COMT. The C/T genotype of C-270T BDNF polymorphism was associated with higher percentage of conceptual responses.
Conclusion:
The results obtained suggest a contribution of studied candidate genes to working memory and executive functions efficiency, connected with prefrontal cortex activity, in healthy subjects.
A number of scales are used to estimate the severity of depression. However, differences between self-report and clinician rating, multi-dimensionality and different weighting of individual symptoms in summed scores may affect the validity of measurement. In this study we examined and integrated the psychometric properties of three commonly used rating scales.
Method
The 17-item Hamilton Depression Rating Scale (HAMD-17), the Montgomery–Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI) were administered to 660 adult patients with unipolar depression in a multi-centre pharmacogenetic study. Item response theory (IRT) and factor analysis were used to evaluate their psychometric properties and estimate true depression severity, as well as to group items and derive factor scores.
Results
The MADRS and the BDI provide internally consistent but mutually distinct estimates of depression severity. The HAMD-17 is not internally consistent and contains several items less suitable for out-patients. Factor analyses indicated a dominant depression factor. A model comprising three dimensions, namely ‘observed mood and anxiety’, ‘cognitive’ and ‘neurovegetative’, provided a more detailed description of depression severity.
Conclusions
The MADRS and the BDI can be recommended as complementary measures of depression severity. The three factor scores are proposed for external validation.
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