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Impulsividad en el trastorno bipolar-II: ¿rasgo, estado o ambos?
Published online by Cambridge University Press: 12 May 2020
Resumen
Antecedentes.
En el trastorno bipolar-II (BP-II), la impulsividad (definida en el DSM-IV-TR como desarrollo de actividades con riesgo excesivo) es uno de los síntomas la hipomanía, pero no está claro si la impulsividad es también un rasgo del BP-II.
Objetivo.
Determinar si la impulsividad es también un rasgo del BP-II.
Métodos.
Ciento treinta y seis pacientes ambulatorios con BP-II derivados consecutivamente (evaluados por depresión en la presentación por un psiquiatra especializado en trastornos del ánimo con la Entrevista Clínica Estructurada para DSM-IV), con autoevaluación del rasgo de impulsividad durante el seguimiento, usando el Cuestionario de Personalidad de la Entrevista Clínica Estructurada para los Trastornos del Eje II del DSM-IV, en una consulta privada. Los rasgos de cambios bruscos del estado de ánimo también fueron autoevaluados, usando el TEMPS-A. La naturaleza del rasgo de impulsividad en el BP-II podría confirmarse si se encontraba (1) una frecuencia relativamente alta, (2) una asociación entre el rasgo de impulsividad y los síntomas de hipomanía pasada, sobre todo, impulsividad, (3) una relación dosis-respuesta entre el número de síntomas de hipomanía pasados y el rasgo de impulsividad, y (4) una asociación entre el rasgo de impulsividad y los rasgos de cambios bruscos del estado de ánimo (un rasgo típico del BP-II).
Resultados.
Sencontró el rasgo de impulsividad en el 41,1% de los pacientes con BP-II. Comparados con los pacientes con BP-II sin impulsividad, entre los pacientes con BP-II con impulsividad había significativamente más hombres, más rasgos de cambios bruscos del estado de ánimo, más síntomas de hipomanía pasados (ánimo irritable, locuacidad, aumento de actividad para conseguir un objetivo) y actividades con riesgo excesivo (es decir, estado de impulsividad), que correspondió a una sobreactividad de riesgo irritable. El estado de impulsividad pasado y el rasgo de impulsividad se asociaron significativamente. El número de síntomas de hipomanía pasados y el rasgo de impulsividad se correlacionaron significativamente. Se encontró una relación dosis-respuesta entre el número de síntomas de hipomanía pasados y el rasgo de impulsividad.
Discusión.
Los resultados sugieren que el rasgo de impulsividad puede ser una característica del BP-II. Debería tenerse en cuenta la limitación de la autoevaluación de los rasgos de personalidad. Estos resultados pueden tener un impacto importante sobre el tratamiento, ya que la combinación de rasgo de impulsividad y cambios bruscos del estado de ánimo puede facilitar las recaídas y los estados mixtos, que los estabilizantes del ánimo podrían prevenir/retardar.
Keywords
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- Copyright © European Psychiatric Association 2008
References
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