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. 2023 Sep 7;23(1):659.
doi: 10.1186/s12888-023-05154-4.

Impulsivity across severe mental disorders: a cross-sectional study of immune markers and psychopharmacotherapy

Gabriela Hjell  1   2 , Jaroslav Rokicki  3   4 , Attila Szabo  3   5 , René Holst  6   7 , Natalia Tesli  3 , Christina Bell  3 , Thomas Fischer-Vieler  3 , Maren Caroline Frogner Werner  3 , Synve Hoffart Lunding  3 , Monica Bettina Elkjær Greenwood Ormerod  3 , Ingrid Torp Johansen  3 , Srdjan Djurovic  8   9 , Thor Ueland  10   11   12 , Ole Andreas Andreassen  3 , Ingrid Melle  3 , Trine Vik Lagerberg  3 , Lynn Mørch-Johnsen  3   6 , Nils Eiel Steen  3 , Unn Kristin Haukvik  3   4   13
Affiliations

Impulsivity across severe mental disorders: a cross-sectional study of immune markers and psychopharmacotherapy

Gabriela Hjell et al. BMC Psychiatry. .

Abstract

Background: Impulsivity is a transdiagnostic feature linked to severe clinical expression and a potential target for psychopharmacological strategies. Biological underpinnings are largely unknown, but involvement of immune dysregulation has been indicated, and the effects of psychopharmacological agents vary. We investigated if impulsivity was associated with circulating immune marker levels and with a range of psychopharmacological treatment regimens in severe mental disorders.

Methods: Impulsivity was assessed in a sample (N = 657) of patients with schizophrenia or schizophreniform disorder (SCZ) (N = 116) or bipolar disorder (BD) (N = 159) and healthy participants (N = 382) using the Barratt Impulsiveness Scale (BIS-11) questionnaire. Plasma levels of systemic immune markers (RANTES, IL-1RA, IL-18, IL-18BP, sTNFR-1) were measured by enzyme immunoassays. Patients underwent thorough clinical assessment, including evaluation of psychotropic medication. Associations were assessed using linear regressions.

Results: Impulsivity was positively associated with SCZ (p < 0.001) and BD (p < 0.001) diagnosis and negatively associated with age (p < 0.05), but not significantly associated with any of the circulating immune markers independently of diagnostic status. Among patients, impulsivity was negatively associated with lithium treatment (p = 0.003) and positively associated with antidepressant treatment (p = 0.011) after controlling for diagnosis, psychotropic co-medications, manic symptoms, and depressive symptoms.

Conclusions: We report elevated impulsivity across SCZ and BD but no associations to systemic immune dysregulation based on the current immune marker selection. The present study reveals associations between impulsivity in severe mental disorders and treatment with lithium and antidepressants, with opposite directions. Future studies are warranted to determine the causal directionality of the observed associations with psychopharmacotherapy.

Keywords: Antidepressants; Bipolar disorder; Chemokine CCL5; Cytokines; Impulsiveness; Interleukin-1; Lithium; Psychopharmacology; Schizophrenia; Tumor necrosis factor.

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Conflict of interest statement

OAA is a consultant for HealthLytix and received speaker's honorarium from Lundbeck and Sunovion. All the other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Impulsivity across individuals with severe mental disorders and healthy individuals. BD bipolar disorder; SCZ, schizophrenia or schizophreniform disorder; HC, healthy participant group. Impulsivity displayed as total scores on Barratt Impulsiveness Scale 11
Fig. 2
Fig. 2
Associations between circulating immune marker levels and impulsivity. X axis: Plasma level of the immune marker (ng/mL). Y axis: Barratt Impulsiveness scale 11, total score. RANTES, Regulated on activation normal T cell expressed and secreted; IL-1RA, Interleukin-1 receptor antagonist; IL-18, Interleukin-18; IL-18BP, Interleukin-18 binding protein; sTNFR1, Soluble tumor necrosis factor receptor 1. SCZ, schizophrenia or schizophreniform disorder; BD bipolar disorder; HC, healthy participant group
See this image and copyright information in PMC

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