The Impact of Sleep Disturbance and Impulsivity on Community Functioning in Patients with Bipolar Disorder

Julia Potter, BA

Brigham and Women’s Hospital – Research Assistant
JuliaPotter poster

Scientific Abstract

Background: Functional impairment in bipolar disorder (BD) persists during periods of euthymia and is a major barrier to full recovery. Sleep disturbance and impulsivity have been characterized as state-independent features of BD and may be particularly relevant to understanding why functional deficits persist outside of mood episodes. The present work aimed to understand the relationship between sleep disturbance and impulsivity in adults with BD, and the effects of each on community function.

Methods: 264 affectively stable adults with BD completed the Barrett Impulsiveness Scale, the Pittsburgh Sleep Quality Index, and the Social Adjustment Scale Self-Report. Participants were administered the Structured Clinical Interview for DSM-IV to confirm BD diagnosis. Using Pearson’s correlations and three linear regression models, we evaluated the relationship between second order factors of impulsivity (attention, non-planning, and motor) and overall sleep quality on social functioning. All regressions were covaried for depressive symptoms, age, race, and sex.

Results: In our regression analyses, we observed (1) in Model 1, an effect of attentional impulsivity (b = 0.24, p<0.001) and depressive symptoms (b=.34, p<0.001) on social functioning; (2) In Model 2, we observed an effect of non-planning impulsivity (b = 0.18, p =0.002), overall sleep quality (b = 0.15, p = 0.01) and depressive symptoms (b=0.35, p<0.001) on social functioning and (3) in Model 3, we observed a main effect of overall sleep quality (b = 0.15, p = 0.01) and depressive symptoms (b = 0.36, p <0.001) (but no effect of motor impulsivity) on social functioning.

Conclusion: The work presented here supports the notion that depressive symptoms (even subthreshold), sleep disturbance, and two subtypes of impulsivity (planning and attentional) negatively influence social functioning in patients with BD. As this work was cross-sectional, future research should aim to understand the direction of this relationship. Our results further emphasize aspects of BD beyond primary affective symptoms that warrant intervention to promote full functional recovery.

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research Areas


Julia Potter, BA, Caitlin Millett, PhD, Katherine Burdick, PhD

Principal Investigator

Katherine Burdick, PhD

Affiliated Website