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Relationship Between Impulsivity and Clinical and Sociodemographic Variables Among Lebanese Patients With Bipolar Disorder

Results of a Cross-Sectional Study

Azzam, Patrick MSc*; Obeid, Sahar PhD†‡§; Haddad, Chadia MPH; Kazour, Francois MD, PhD*†‡∥¶; Nabbout, Rita PhD*; Hallit, Souheil PharmD, MSc, MPH, PhD#**; Azar, Jocelyne MD*§††

The Journal of Nervous and Mental Disease: July 2019 - Volume 207 - Issue 7 - p 596–603
doi: 10.1097/NMD.0000000000001012
Original Article

Impulsivity is a psychiatric symptom that seems to be more prevalent in some mental disorders such as bipolar disorders (BDs). It is a trait that seems to be influenced by many clinical and sociodemographic variables across BD. To examine the relationship between impulsivity and these variables, we performed a cross-sectional study on 50 patients diagnosed with BD and 50 healthy subjects. Both groups were administered the Barratt Impulsiveness Scale; the Structural Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, for borderline personality disorder; the Beirut District Scale; and the Athens Insomnia Scale to assess impulsivity, borderline personality disorder, psychological distress, and sleep disturbances, respectively. A significantly higher nonplanning impulsivity (p = 0.001), motor impulsivity (p < 0.0001), total impulsivity (p < 0.0001), body mass index (p < 0.0001), and insomnia (p = 0.002) were found in subjects with BDs compared with healthy ones. Exposure to violence (odds ratio [OR] = 7.63), the loss of a parent (OR = 3.83), being a current smoker (OR = 14.56), and a higher motor impulsivity score (OR = 1.27) were all significantly associated with the presence of BD. Impulsivity was shown to be strongly associated with the presence of a diagnosis of BD, and further studies are warranted to fully characterize it through the course of the illness.

*Faculty of Sciences, Lebanese University, Beirut;

Psychiatric Hospital of the Cross, Jal Eddib;

Faculty of Philosophy and Human Sciences, Holy Spirit University of Kaslik (USEK), Jounieh;

§Faculty of Pedagogy, Lebanese University, Beirut, Lebanon;

INSERM U930, équipe 4 “Troubles affectifs,” Université François-Rabelais de Tours, Tours, France;

Faculty of Medicine, Saint-Joseph University, Beirut;

#Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh;

**Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie (INSPECT-LB), Beirut; and

††Faculty of Sciences, Lebanese University, Fanar, Lebanon.

Souheil Hallit and Jocelyne Azar are last co-authors.

Send reprint requests to Souheil Hallit, PharmD, MSc, MPH, PhD, Building 560, Street 8, 1st floor, Biakout, Lebanon. E-mail:; and Jocelyne Azar, MD, Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon. E-mail:

This work has been done in the frame of the “Behavioral and Cognitive Neuroscience Master 2 program,” Faculty of Sciences, Lebanese University.

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