Comparing impulsivity, risk taking behavior and neurocognitive functions on bipolar disrder comorbidity of adhd versus healthy controls

Objective: Comorbid bipolar disorder (BPD) and attention deficit hiperactivity disorder (ADHD) (BPD+ADHD) is high in the adult population. Both conditions present with neurocognitive deficits and impulsive behavior. The aim of this study is to examine impulsivity, risk taking behavior and neurocognitive fuctions in adult BPD+ADHD in comparison to BPD, DEHB and healthy controls (HC) to explore whether comorbidity of two conditions would have a deleterious effect on the abovementioned parameters. Methods: Impulsivity, risk taking behavior and a series of neurocognitive functions were assessesed in patients with BPD (n=37), ADHD (n=43), BPD+ADHD (n=21) in comparison to HC (n=51). Non-parametric comparison and correlation tests were used for continious variables whereas categorical variables were compared using Chi-square analysis. Results: All patient groups performed poorly on executive functions, attention, processing speed and exhibited high impulsivity in comparison to HC. In addition to that, compared to HC, BPD performed poorly on verbal learning, verbal memory, working memory and verbal fluency; BPD+ADHD performed poorly on verbal fluency; ADHD performed poorly on working memory. There was no significant differences on any of the neurocognitive measures between BPD and BPD+ADHD. However BPD performed poorly on verbal learning and memory; BPD and BPD+ADHD groups performed poorly on some of attention, processing speed and verbal fluency tests compared to ADHD. All patient groups scored significantly higher on all impulsivity measures than HC. Scores of ADHD and BPD+ADHD were also significantly higher than that of BPD. All patient groups exhibited significantly high impulsivity on the response inhibition test compared to HC. Risk taking behavior scores did not differ significantly between the groups. Conclusion: Our results show that adults with comorbid ADHD and BD exhibit similar neurocognitive deterioration to individuals with BPD alone and similar increased impulsive behavior to adults with ADHD alone, meaning that having the comorbid condition may lead to poorer course of illness and treatment difficulties. Further research with larger sample size to assess the role of treatment on the findings and the outcome is needed. Key Words: bipolar disorder, attendion deficit hyperactivity disorder, impulsivity, risk taking behavior, neurocognitive functions