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Psychiatry"],"abstract":"<jats:p>Altered risk-taking propensity is an important determinant of functional impairment in bipolar disorder. However, prior studies primarily assessed patients with chronic illness, and risk-taking has not been evaluated in the early illness course. This study investigated risk-taking behavior in 39 euthymic early-stage bipolar disorder patients aged 16\u201340 years who were treated within 3 years from their first-episode mania with psychotic features and 36 demographically-matched healthy controls using the Balloon Analog Risk Task (BART), a well-validated risk-taking performance-based paradigm requiring participants to make responses for cumulative gain at increasing risk of loss. Relationships of risk-taking indices with symptoms, self-reported impulsivity, cognitive functions, and treatment characteristics were also assessed. Our results showed that patients exhibited significantly lower adjusted scores (i.e., average balloon pumps in unexploded trials) (<jats:italic>p<\/jats:italic>= 0.001), lower explosion rate (<jats:italic>p<\/jats:italic>= 0.007) and lower cumulative scores (<jats:italic>p<\/jats:italic>= 0.003) than controls on BART, indicating their suboptimal risk-taking performance with increased propensity for risk aversion. Risk-taking indices were not correlated with any symptom dimensions, self-reported impulsivity, cognitive functions or antipsychotic dose. No significant difference was observed between patients with and without antipsychotic medications on self-reported impulsivity or any of the BART performance indices. This is the first study to examine risk-taking behavior in early-stage bipolar disorder with history of psychosis and indicates that patients displayed altered risk-taking with increased risk aversion compared with controls. Further research is needed to clarify longitudinal trajectory of risk-taking propensity and its relationships with psychosis and functional outcome in the early stage of bipolar disorder.<\/jats:p>","DOI":"10.3389\/fpsyt.2021.763545","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T09:26:47Z","timestamp":1637227607000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Altered Risk-Taking Behavior in Early-Stage Bipolar Disorder With a History of Psychosis"],"prefix":"10.3389","volume":"12","author":[{"given":"Sandra Chi Yiu","family":"Wong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Chung Mun","family":"Ng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joe Kwun Nam","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha Sin Ki","family":"Luk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon Sai Yu","family":"Lui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric Yu Hai","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wing Chung","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/0010-0277(94)90018-3","article-title":"Insensitivity to future consequences following damage to human prefrontal cortex","volume":"50","author":"Bechara","year":"1994","journal-title":"Cognition."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2141","DOI":"10.1017\/S0033291720003086","article-title":"Impulsivity, decision-making and risk-taking behaviour in bipolar disorder: a systematic review and meta-analysis","volume":"50","author":"Ramirez-Martin","year":"2020","journal-title":"Psychol Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1017\/S0033291712001304","article-title":"Increased salience of gains versus decreased associative learning differentiate bipolar disorder from schizophrenia during incentive decision making","volume":"43","author":"Bambrilla","year":"2013","journal-title":"Psychol Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.jpsychires.2015.04.007","article-title":"Integrating frequency and magnitude information in decision-making in schizophrenia: an account of patient performance on the Iowa Gambling Task","author":"Brown","year":"2015","journal-title":"J Psychiatry Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1017\/S0033291718002660","article-title":"Decision-making ability in psychosis: a systematic review and meta-analysis of the magnitude, specificity and correlates of impaired performance on the Iowa and Cambridge Gambling Tasks","volume":"49","author":"Woodrow","year":"2019","journal-title":"Psychol Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/j.1399-5618.2008.00657.x","article-title":"Conceptualizing impulsivity and risk taking in bipolar disorder: importance of history of alcohol abuse","volume":"11","author":"Holmes","year":"2009","journal-title":"Bipolar Disord."},{"key":"B7","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1017\/S1355617713000015","article-title":"Can risk-taking be an endophenotype for bipolar disorder? 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