Research report Behavioural addictions in bipolar disorder patients: Role of impulsivity and personality dimensions Marco Di Nicola ⁎, Daniela Tedeschi, Marianna Mazza, Giovanni Martinotti, Desiree Harnic, Valeria Catalano, Angelo Bruschi, Gino Pozzi, Pietro Bria, Luigi Janiri Institute of Psychiatry, Bipolar Disorder Unit, Catholic University Medical School, Rome, Italy article info abstract Article history: Received 12 August 2009 Received in revised form 19 December 2009 Accepted 20 December 2009 Available online 18 January 2010 Background: Behavioural addictions (BAs) can be understood as disorders characterized by repetitive occurrence of impulsive and uncontrolled behaviours. Very few studies have investigated their association with mood disorders. The present study was undertaken to determine the prevalence of the main behavioural addictions in a sample of bipolar outpatients in euthymic phase or stabilised by medications and to investigate the role of impulsivity and temperamental and character dimensions. Methods: One-hundred-fifty-eight Bipolar Disorder (BD) (DSM-IV) outpatients were assessed with tests designed to screen the main behavioural addictions: pathological gambling (SOGS), compulsive shopping (CBS), sexual (SAST), Internet (IAD), work (WART) and physical exercise (EAI) addictions. TCI-R and BIS-11 were administered to investigate impulsivity and personality dimensions mainly associated with BAs. The clinical sample has been compared with 200 matched healthy control subjects. Results: In bipolar patients, 33% presented at least one BA respect to the 13% of controls. Significantly higher scores at the scales for pathological gambling (p b .001), compulsive buying (p b .05), sexual (p b .001) and work addictions (p b .05) have been found. Self-Directness (p = .007) and Cooperativeness (p = .014) scores were significantly lower while impulsivity level was significantly higher (p = .007) in bipolar patients with BA than those without BA. Conclusions: To our knowledge, this is the first study investigating the prevalence of behavioural addictions in BD showing a significant association of these disorders. BAs are more frequent in bipolar patients than in healthy controls and are related to higher impulsivity levels and character immaturity. © 2010 Elsevier B.V. All rights reserved. Keywords: Bipolar disorder Behavioural addictions Impulsivity Personality dimensions 1. Introduction Behavioural addictions (BAs) can be understood as disorders characterized by repetitive occurrence of impulsive and uncontrolled behaviours that cause psychological, social and working problems, sometimes also legal and economic consequences. Core features of these disorders are failure to resist an impulse, drive or temptation to perform some act harmful to oneself and/or others, an increasing sense of tension or excitement before acting out, a sense of pleasure, and gratification or release at the time of the behaviour or shortly thereafter (Leioyeux et al., 2000). Behavioural addictions include indulgence in gambling, shopping, sex, Internet, affective relationships, work, physical activity or even food. All these activities are part of life and do not have any negative impact in the normal course; in fact, it is not the object that determine the addiction but a particularly intense and rigid relationship between the addict and the activity of choice (Keane, 2004). DSM-IV does not contemplate any category neither diagnostic criteria for BAs with the exception of pathological Journal of Affective Disorders 125 (2010) 82–88 ⁎ Corresponding author. Institute of Psychiatry, Bipolar Disorder Unit, Catholic University Medical School, Largo Agostino Gemelli, 8, Rome 00168, Italy. Tel.: +39 3406860419; fax: +39 0697276550. E-mail address: mdnicola@libero.it (M. Di Nicola). 0165-0327/$ – see front matter © 2010 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2009.12.016 Contents lists available at ScienceDirect Journal of Affective Disorders journal homepage: www.elsevier.com/locate/jad