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14-04-2011 | Mental health | Article

Criminal behavior linked to impaired response inhibition in BD


Free abstract

MedWire News: Self-reported criminal behavior is associated with impaired response inhibition, antisocial personality disorder (ASPD) symptoms, and a predominately manic course of illness in bipolar disorder (BD) patients, research suggests.

"Arrest and incarceration are potential complications of bipolar disorder, which has a higher prevalence among incarcerated individuals than in the community," write Alan Swann (University of Texas Health Science Center, Houston, USA) and team.

They add: "Criminal behavior in bipolar disorder may be related to substance use disorders, personality disorders, or other comorbidities potentially related to impulsivity."

To investigate, the team recruited 112 patients with bipolar disorder who completed questionnaires about previous criminal behavior.

All of the participants were assessed for psychiatric symptoms using the Change version of the Schedule for Affective Disorders and Schizophrenia, and course of illness was assessed using a life chart based on the Structured Clinical Interview for DSM-IV.

ASPD symptoms were assessed in structured interviews, with scores ranging 0 for no symptoms to 14 for high levels of symptoms, and impulsivity was evaluated using the Barratt Impulsiveness Scale questionnaire and a variety of response inhibition measures.

In total, 29 patients reported a history of previous criminal convictions, the researchers report in the journal Bipolar Disorders.

They found that around 51% of BD patients without a criminal history had a substance abuse disorder compared with 82% of those with such a history.

BD patients with a criminal history also had higher mean ASPD symptom scores (7.1 vs 2.6), were more likely to have attempted suicide (65% vs 50%), and were more likely to have a history or recurrent, mainly manic, episodes (41% vs 21%) than those without such a history.

Furthermore, patients with a criminal history had higher levels of impulsivity than those without, as reflected by impaired response inhibition measures, but the two groups did not differ in questionnaire-measured impulsivity.

Logit analysis revealed that impaired response inhibition and ASPD symptoms, but not substance use disorder, were significantly associated with a history of criminal behavior.

Current mood symptoms did not affect the findings, the researchers note.

Swann and team conclude: "In this community sample, a self-reported history of criminal behavior is related to ASPD symptoms, a recurrent and predominately manic course of illness, and impaired response inhibition in bipolar disorder, independent of current clinical state."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Mark Cowen

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