Hostname: page-component-6bf8c574d5-gr6zb Total loading time: 0 Render date: 2025-02-25T09:25:41.014Z Has data issue: false hasContentIssue false
  • English
  • Français

Impulsividad y conducta: bases psicobiológicas y tratamientos farmacológicos

Published online by Cambridge University Press:  12 May 2020

J. C. Pascual
J. C. Pascual*
Affiliation:
Hospital de la Santa Creu i Sant Pau.Barcelona
Get access

Extract

La impulsividad es un aspecto fundamental de la conducta humana y una característica básica de múltiples trastornos como el Trastorno Bipolar, Trastornos de la Personalidad Límite y Antisocial, Trastornos relacionados con sustancias o Trastornos de la conducta alimentaria. Además, es responsable en gran medida de la morbilidad y mortalidad asociada a estos trastornos. Si bien la impulsividad se menciona como criterio diagnóstico de varias enfermedades en el DSM-IV, no hay un acuerdo definitivo en la definición de la conducta impulsiva, así como tampoco en su rol en las enfermedades mentales ni en sus sistemas de medida.

Type
Sección Española
Information
European Psychiatry (Ed. Española) , Volume 10 , Issue 6 , September 2003 , pp. 399 - 405
Copyright
Copyright © European Psychiatric Association 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Ed 4. Washington, DC, APA, 1994, p 654.Google Scholar
Eysenck, SB, Eysenck, HJ. The place of impulsiveness in a dimensional system of personality description. Br J Soc Clin Psychol 1977;16:57–68.CrossRefGoogle Scholar
Patton, JH, Stanford, MS, Barratt, ES. Factor structure of the Barratt Impulsiveness Scale. J Clin Psychol 1995;1:768–774.3.0.CO;2-1>CrossRefGoogle Scholar
Gray, JA. A model of the limbic system and basal banglia: applications to onsieta and schizophrenia, in the Cogniíive Neurosciences. Edited by Gazzaniga, MS.Cambridge, Mass, MIT Press, 1995, pp 1165–1176.Google Scholar
RacBin, R. The Scicnce of Self Control. Cambridge, Mass, Harvard University Press, 2000.Google Scholar
Stein, DJ, Hollander, E, Simeón, D, Cohén, L. lmpulsivity Scores in patients wilh obsessive-compulsivc disorder. J Nerv Ment Dis 1994;182:240–241.CrossRefGoogle Scholar
Stein, DJ, Trestmen, RL, Mitropoulou, V, Coccaro, EF, Hollander, E, Siever, U. lmpulsivity and seroioncrgic lunction in compulsivo personality disorder. J Neuropsychialry Clin Ncurosci 1996;8:393–398.Google Scholar
Moellcr, FG, Barratt, ES, Dougherty, DM, Schmitz, JM, Swann, AC. Psychiatric aspeets of lmpulsivity (Perspectives: reviews and overviews). Am J Psychiatry 2001;158:1783–1793.Google Scholar
Eveden, JL. The pharmacology of impulsive behaviour in rats, VII; the effects of serotonergic agonists and antagonists on responding under a discrímination task using unreliable visual stimuli. Psychopharmacology 1999;146:422–431.CrossRefGoogle Scholar
Puumala, T, Sirvió, J. Changes in activities of dopamine and serotonin systems in the frontal córtex underiie poor choice accuracy and impulsivity of rats in an attention task. Neuroscience 1998; 83: 489–499.CrossRefGoogle Scholar
Coccaro, EF, Central serotonin and impulsive aggression. Br J Psychiatry 1989;155 (suppl): 52–62.CrossRefGoogle Scholar
Dichiara, G, Camba, R, Spano, PR. Evidence for inhibition by brain serotonin of mouse killing behavior in rats. Nature 1971;233:272–273.CrossRefGoogle Scholar
Doudet, D» Hommer D, Higley, JDet al. Cerebral glucose metabolism, CSF 5-HIAA levels, and aggresive behavior in Rhesus monkeys. Am J Psychiatry 1995;152:1782–1787.Google Scholar
Brown, GL, Ebert, MH, Goyer, PF, et, al. Aggresion, suicide, and serotonin: relationships to CSF amine metabolites. Am J Psychiatry 1982;139:741–746.Google Scholar
Coccaro, EF, Siever, U, Klar, HM, et, al. Serotonergic studies in patients with affective and personality disorders: correlates with suicidal and impulsive aggresive behavior. Arch Gen Psychiatry 1989;46:587–599.CrossRefGoogle Scholar
Coccaro, EF, Murphy, DL. Serotonin in major psychiatric disorders. Washington: American Psychiatry Press, 1990;27–46.Google Scholar
Linnoila, M, Virkkunen, M, Scheinin, M, et, al, Low cerebrospinal fluid 5-hidrox-yindoleacetic acid concentration differentiates impulsive from non-impulsive violent behavior. Life Sci 1983;33:2609–2614.CrossRefGoogle Scholar
Verkes, RJ, Van, der Mast RC, Kerkhof, Ad JFM, Fekkes, D, Hengeveld, MW, Tuyl, JP, Van Kempen, G.Platelet serotonin, monoamine oxidase activity, and 3H paroxetine binding related to impulsive suicide attempts and borderline personality disorder. Biol Psychiatry 1998;43:740–746.CrossRefGoogle ScholarPubMed
Tadano, T, Abe, Y, Morikawa, Y, et, al. Involvement of dopaminergic neurons in mouse-killing aggression in rats. Methods Find Exp Clin Pharmacol 1997;19:527–531.Google ScholarPubMed
Matsumoto, K, Ojima, K, Watanabe, H. Noradrenergic denervation attenuates de-sipramina enhancement of aggresive behavior in isolated mice. Pharmacol Biochem Behav 1995;50:481–484.CrossRefGoogle Scholar
Eichelman, B. Neurochemical and psychopharmacologic aspects of aggressive In Meltzer HY: Psycho- pharmacology: The Third Generation of Progress. New York, Raven Press, 1987;697–704.Google Scholar
Blair, RJ, Cipolotti, L. Impaired social response reversal: a case of "acquired so ciopathy." Brain 2000;123:1122–1141.CrossRefGoogle Scholar
Jentsch, JD, Taylor, JR. Impulsivity resulting from frontostriatal dysfunction in drug abuse; implications for the control of behavior by reward-reíated stimuli. Psychopharmacology (Berl) 1999;146:373–390.CrossRefGoogle ScholarPubMed
Bechara, A, Damasio, H, Tranel, D, Damasio, AR. Deciding advantageously before knowing the advantageous strategy. Science 1997;275:1293–1295.CrossRefGoogle ScholarPubMed
Raine, A, Buchsbaum, M, LaCasse, L. Brain abnormalities in murderers indicated by positron emission tomography. Biol Psychiatry 1997;42:495–508.CrossRefGoogle ScholarPubMed
Siever, LJ, Buchsbaum, M, New, AS, et, al. d,l-fenfluramine response in impulsive personality disorder assessed with 18F-fluorodeoxyglucose positron emission to mography. Neuropsychopharmacology 1999;20:413–423.CrossRefGoogle Scholar
Claridge, G. Origins of mental illness. New York: Blackwell, 1985.Google Scholar
Gardner, DL, Cowdry, RW. Positive effects of carbamazepine on behavioral dys-controí in borderline personality disorder. Am J Psychiatry 1986;143:519–522.Google ScholarPubMed
Barratt, ES, Stanford, MS, Felthous, AR, Kent, TA. The effects of phenytoin on impulsive and premeditated aggression: a controlled study. J Clin Psychopharmacol 1997;17:341–349.CrossRefGoogle ScholarPubMed
Greendyke, RM, Kanter, DR, Schuster, DB, Verstreate, S, Wootton, J, Propanolol treatment of assaultive patients with organic brain disease: a double-blind crossover, píacebo-controlled study. J Nerv Ment Dis 1986; 174: 290–294.CrossRefGoogle ScholarPubMed
Greendyke, RM, Kanter, DR. Therapeutic effects of pindolol on behavioral disturbances associated with organic brain disease: a double-blind study. J Clin Psychiatry 1986;47:423–426.Google ScholarPubMed
Brown, RT, Sleator, EK. Methylphenidate in hyperkinetic children: differences in dose effects on impulsive behavior. Pediatrics 1979;64:408–411.Google ScholarPubMed
Musten, LM, Firestone, P, Pisterman, S, Bennett, S, Mercer, J. Effects of methylphenidate on preschool children with ADHD: cognitive and behavioral functions. J Am Child Adolesc Psychiatry 1997;36:1407–1415.CrossRefGoogle ScholarPubMed
Malone, MA, Swanson, JM. Effects of methylphenidate on impulsive responding in children with attention-deficit hyper- activity disorder. J Child Neurol 1993;8:157–163.CrossRefGoogle Scholar
Norden, MJ. Fluoxetine in borderline personality disorder. Progress in Neuropsychopharmacology and Biological Psychiatry 1989;13:885–893.CrossRefGoogle ScholarPubMed
Cornelius, JR, Soloff, PH, Perel, JMet al. A preliminary trial of fluoxetine in refractory borderline patients. J Cíin Psychopharmacol 1991;11:116–120.Google ScholarPubMed
Markovitz, PJ, Calabrese, JR, Schultz, SC, et, al. Fluoxetine in the treatment of borderline and schizotypal personality disorders. Am J Psychiatry 1991;148:1064–1067. .Google ScholarPubMed
Kavoussi, RJ, Liu, J, Coccaro, EF. An open trial of sertraline in personality disordered patients with impulsive aggression. J Clin Psychiatry 1994;55:137–141.Google ScholarPubMed
Markovitz, PJ, Wagner, SC. An open trial of venlafaxine in borderline personality disorder. Presented at the 35 th annual meeting of the New Clinical Drug Evaluation Unit; 1995; May; Orlando.Google Scholar
Salzman, C, Wolfson, AN, Schatzberg, A, et, al. Effect of fluoxetine on anger in. symptomatic volunteers with borderline personality disorder. J Clin Psychopharmacol 1995;15:23–25.Google ScholarPubMed
Coccaro, EF, Kavoussi, RJ. Fluoxetine and impulsive aggresive behavior in personality-disordered subjects. Ach Gen Psychiatry 1997;54:1081–1088..CrossRefGoogle Scholar
McDougle, CJ, Naylor, ST, Cohén, DJ, Volkmar, FR, Heninger, GR, Price, LH. A double-blind, placebo-controlled study of fluvoxamine in adults with autistic disorder. Arch Gen Psychiatry 1996;53:1001–1008.CrossRefGoogle ScholarPubMed
Vartiainen, H, Tiihonen, J, Putkonen, A, Koponen, H, Virkkunen, M, Hakola, P.Lehto H. Citalopram, a selective serotonin reuptake inhibitor, in the treatment of aggression in schizophrenia. Acta Psychiatr Scand 1995;91:348–351.Google Scholar
Soloff, PH, George, A, Nathan, RS, Schulz, PM, Ulrich, RF, Perel, JM. Progress in pharmacotherapy of borderline disorders. A double-blind study of amitryptiline, ha-loperidol and placebo. Arch Gen Psychiatry 1986;43:691–697.Google ScholarPubMed
Cowdry, RW, Gardner, DL. Pharmacotherapy of borderline personality disorden. Alprazolam, carbamazepine, trifluoperazine and tranylcypromine. Arch Gen Psychiatry 1988;45:111–119.CrossRefGoogle Scholar
Soloff, PH, Cornelius, J, George, A, et, al. Efficacy of phenelzine and haloperídol in borderline personality disorder. Arch Gen Psychiatry 1993;50:377–385.CrossRefGoogle ScholarPubMed
American, Psychiatric Association. Practice Guideline for the treatment of patients with Borderline Personality Disorder. Am J Psychiatry 2001;158 (Supp): 10.Google Scholar
Leone, NF. Response of Borderline Patients to loxapine and chorpromazine. J Clin Psychiatry 1982;43:148–150.Google Scholar
Kutcher, S, Papatheodorou, G, Reiter, S, et, al. The successful pharmacologic treatment of adolescent and young adults with borderline personality disorder: A preliminary open trial of flupenthixol. J Psychiatr Neurosci 1995;20 (2):113–118.Google Scholar
Teicher, M, Glod, C, Aaronson, S, Gunter, P, Schatzberg, A, Colé, J. Open assessment of the safety and efficacy of thíorídazine in the treatment of patients with borderline personality disorder. Psychopharmacol Bull 1989;25:535–549.Google ScholarPubMed
Cornelius, JR, Soloff, PH, Perel, JM, et al: Continuation pharmacotherapy of bor- !'■ derline personality disorder with haloperídol and phenelzine. Am J Psychiatry' 1993;150:1843–1848.Google Scholar
Katz, IR, Jeste, DV, Mintzer, JE, Clyde, C, Napolitano, J, Brecher, M. Comparison of risperidone and placebo for psychosis and behavioral disturbances associated with dementia: a randomized, double-blind trial: Risperidone Study Group. J Clin Psychiatry 1999;60:107–115.CrossRefGoogle ScholarPubMed
de, Deyn PP, Rabheru, K, Rasmussen, A, Bocksberger, JP, Dautzenberg, PL, Erikson, S, Lawlor, BA.A randomized trial of risperidone, placebo, and haloperídol for behavioral symptoms of dementia. Neurology 1999;53:946–955.Google Scholar
McDougle, CJ, Homes, JP, Carlson, DC, Pelton, GH, Cohén, DJ, Price, LH. A double blind, placebo-controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders. Arch Gen Psychiatry 1998;55:633–641.CrossRefGoogle ScholarPubMed
Findling, RL, McNamara, NK, Branicky, LA, Schuchter, MD, Lemon, E, Blumer, JL. A double-blind pilot study of risperidone in the treatment of conduct disorder. J Am Acad Child Adolesc Psychiatry 2000;39:509–516.CrossRefGoogle ScholarPubMed
Frankenburg, F, Zanarini, MC. Clozapine treatment of borderline patients: a preli- ''. minary study. Compr Psychiatry 1993;34:402–405.CrossRefGoogle Scholar
Benedetti, F, Sforzini, L, Colombo, C, Maffei, C, Smeraldi, E. Low-dose clozapine in acute andxontinuation treatment of severe borderline personality disorder. J Clin Psychiatry 1998;59:103–107.CrossRefGoogle ScholarPubMed
Hirose, S. Efféctive treatment of aggression and impulsivity in antisocial personality disorder with risperidone. Psychiatry.Clin Neurosci 2001;55 (2):161–162.CrossRefGoogle ScholarPubMed
Schulz, SC, Camlin, KL, Berry, S, Friedman, L. Risperidone for borderline personality disorder: a double blind study, in Proceedings of the 39th Annual Meeting of the American College of Neuropsychopharmacology. Nashville, Tenn, ACNP, 1999.Google Scholar
Soler, J, Campins, MJ, Pérez, V, Puigdemont, D, Pérez-BIanco, F, Álvarez, E. Olan-zapina y terapia grupal cognitivo-conductual en trastomo límite de la personalidad. Actas Esp Psiquiatr 2001;29 (2):85–90.Google Scholar
Zanarini, MC, Frankenburg, MD. Olanzapine treatment of female borderline per-v sonality disorder patients: A double-blind, placebo-controlled pilot study. J Clin Psychiatry 2001;62:849–854.CrossRefGoogle Scholar
Sheard, MH, Marini, JL, Bridges, CI, Wagner, E. The effect of li thium on impulsive aggresive behavior in man. Am J Psychiatry 1976;133:1409–1413.Google Scholar
Tyrer, SP, Walsh, A, Edwards, DE, et al. Factors associated with good response to lithíum in aggressive mentally handicapped subjects. Prog Neuropsychopharmacol Biol Psychiatry 1984;8:751–755.CrossRefGoogle ScholarPubMed
Craft, M, Ismail, IA, Krishnamurthi, D, et, al. Lithium in the treat ment of aggression in mentally handicapped patients: a double blind trial. Br J Psy chiatry 1987;150:685–689.CrossRefGoogle Scholar
Campbell, M, Adams, PB, Small, AM, Kafantaris, V, Silva, RR, Shell, J, Perry, R, Overall, JE.Lithium in hospitalized aggressive children with conduct disorder: a double-blind and placebo-controlled study. J Am Acad Child Adolesc Psychiatry 1995;34:445–453.CrossRefGoogle ScholarPubMed
Malone, RP, Delaney, MA, Luebbert, JF, Cater, J, Campbell, M. A double-blind placebo-controlled study of lithium in hospitalized aggressive children and adolescents with conduct disorder. Arch Gen Psychiatry 2000;57:649–654.CrossRefGoogle ScholarPubMed
Rifkin, A, Karajgi, B, Dicker, R, Perl, E, Boppana, V, Hasan, N, Pollack, S.Lithium treatment of conduct disorders in adolescents. Am J Psychiatry 1997;154:554–555.Google ScholarPubMed
Tariot, PN, Erb, R, Podgorski, CA, Cox, C, Patel, S, Jakimovich, L, Irvíne, C.Efficacy and tolerability of carbamazepine for agitation and aggression in dementia. Am J Psychiatry 1998;155:54–61.CrossRefGoogle ScholarPubMed
Neppe, VM. Carbamazepine as adjunctive treatment in nonepileptic chronic inpatients with EEG temporal Iobe abnormalities. J Clin Psychiatry 1983; 44: 326–331.Google Scholar
Cueva, JE, Overall, JE, Small, AM, Armenteros, JL, Perry, R, Campbell, M. Carbamazepina in aggresive children with conduct disorder: a double-blind and placebo-controlled study. J Ám Child Adolesc Psychiatry 1996;35:480–490.CrossRefGoogle Scholar
De, la Fuente J, Lotstra, F. A trial of carbamazepine in borderline personality disorder. Eur Neuropsychopharmacol 1994;4:479–486.Google Scholar
Giaka, WJ, Seibyl, JP, Mazure, CM. Valproate ín the treatment of temper out bursts. J Clin Psychiatry 1990;51:525.Google Scholar
Keck, PE, McElroy, SL, Friedman, LM. Valproate and carbamazepine in the treat ment of panic and posttraumatic stress disorders, withdrawal states, and behavioral dyscontrol syndromes. J Clin Psychopharmacol 1992;12:36–41.CrossRefGoogle Scholar
Wilcox, JA. Divalproex sodium as a treatment for borderline personality disorder. Ann Clin Psychiatry 1995;7:33–37.CrossRefGoogle ScholarPubMed
Stein, DJ, Simeón, D, Frenkel, M, Mohammed, NI, Hollander, E. An open trial of valproate in borderline personality disorder. J Clin Psychiatry 1995;56:506–510.Google ScholarPubMed
Kavoussi, RJ, Coccaro, EF. Divalproex sodium for impulsive aggresive behavior in patients with personality disorder. J Clin Psychiatry 1998:59:676–680.CrossRefGoogle Scholar
Donovan, SJ, Stewart, JW, Nunes, EV, Quitkin, FM, Parídes, M, Daniel, W, Susser, E, Klein, DF.Divalproex treatment for youth with explosive temper and mood lability: a double blind, placebo-controlled crossover design. Am J Psychiatry 2000;157:818–820.CrossRefGoogle ScholarPubMed
Hollander, E, Alien, A, López, RP, Bíenstock, C, Grossman, R, Siever, L, Margolin, L, Stein, D.A preliminary double-blind, placebo-controlled trial of divalproex sodium in borderline personalitydisorder. J Clin Psychiatry 2001;62:199–203.CrossRefGoogle Scholar
Pinto, OC, Akiskal, HS. Lamotrigine as a promising approach to borderline personality: an open case series without concurrent DSM-IV major mood disorder. J Affect Disord 1998;51:333–343.CrossRefGoogle ScholarPubMed