Impulsivity has for long time been neglected in bipolar mood disorder (BPD). The concept of BPD has changed beyond clinical presentations of bipolarity to include personality, affective temperaments and important comorbidities. These changes have allowed more focused research into the evolving concepts of impulsivity. Increased impulsivity has been associated with all phases of bipolar disorder (mania, mixed and depression) including inter-episode euthymic phases. The present concept of impulsivity differentiates state and trait impulsivity; both have been associated with bipolarity. Sub-traits of impulsivity (motor activation, attention, lack of planning) have been demonstrated to influence specific phases of bipolar disorder. Recent work on emotional processing and cognitive control offers additional insight into the role of increased impulsivity in bipolar disorder. Data suggests that impulsivity changes the presentation of acute BPD symptoms and increases the risk for aggressive and suicidal behaviour, influences the course of BPD, increases the risk of complications and worsens the long-term prognosis. Data on specific therapeutic effects on impulsivity are scarce in BPD. The authors have endeavoured to offer clinically relevant data on impulsivity and therapeutic implications for everyday clinical use.
Keywords: impulsivity, bipolar disorder