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Bipolar disorder and antisocial personality disorder (ASPD) are each associated with increased impulsivity. What happens in the course of illness when the two conditions co-occur, as they often do? Using careful, structured, clinical interviews and impulsivity rating scales, investigators compared 61 patients with bipolar I disorder without Axis II disorder, 34 with ASPD without bipolar disorder, 24 with both bipolar I disorder and ASPD, and 78 nonpsychiatric comparison subjects.
Patients were assessed when clinically stable (i.e., with medication dose changes <20% in the previous 2 weeks). Of the 85 patients with bipolar illness, 68% and 60% had histories of substance and alcohol use disorders, respectively. Of the patients with both bipola…