{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:30:56Z","timestamp":1792013456633,"version":"4.4.0"},"reference-count":74,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T00:00:00Z","timestamp":1664928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London"},{"name":"Maudsley NHS Foundation Trust and King\u2019s College London"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Impulsive behaviour is a key characteristic of mania in bipolar disorder (BD). However, there is mixed evidence as to whether impulsivity is a trait feature of the disorder, present in the euthymic state in the absence of mania. The aim of this systematic review and meta-analysis was to examine whether impulsivity is elevated in euthymic BD in comparison to controls. Electronic databases were searched for papers published until April 2022 reporting data on a self-report or behavioural measure of impulsivity in a euthymic BD group and a healthy control group. In total, 46 studies were identified. Euthymic BD showed significantly higher levels of self-reported impulsivity compared to controls (large effect size). Euthymic BD also showed significantly higher levels of impulsivity on response inhibition and inattention tasks, with moderate and large effect sizes, respectively. Only two studies measured delay of gratification, finding no significant differences between groups. Our results suggest impulsivity may be a trait feature of BD, however longitudinal cohort studies are required to confirm whether elevated impulsivity is present before illness onset. Future research should establish whether cognitive interventions are beneficial in improving impulsivity in BD.<\/jats:p>","DOI":"10.3390\/brainsci12101351","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T00:07:43Z","timestamp":1665187663000},"page":"1351","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Impulsivity in Bipolar Disorder: State or Trait?"],"prefix":"10.3390","volume":"12","author":[{"given":"Rachel Primo","family":"Santana","sequence":"first","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5834-8307","authenticated-orcid":false,"given":"Jess","family":"Kerr-Gaffney","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7750-8230","authenticated-orcid":false,"given":"Anda","family":"Ancane","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2291-6952","authenticated-orcid":false,"given":"Allan H.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AB, UK"},{"name":"South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Publishing. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.jad.2011.06.059","article-title":"Is cerebellar volume related to bipolar disorder?","volume":"135","author":"Rocha","year":"2011","journal-title":"J. Affect. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1177\/0004867418783062","article-title":"Impulsivity predicts illness severity in long-term course of bipolar disorder: A prospective approach","volume":"52","author":"Rote","year":"2018","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jad.2014.04.051","article-title":"Cognitive functions in euthymic Egyptian patients with bipolar disorder: Are they different from healthy controls?","volume":"166","author":"Okasha","year":"2014","journal-title":"J. Affect. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1080\/13546805.2017.1324951","article-title":"Are self-rated and behavioural measures of impulsivity in bipolar disorder mainly related to comorbid substance use problems?","volume":"22","author":"Bauer","year":"2017","journal-title":"Cogn. Neuropsychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1111\/j.1399-5618.2010.00806.x","article-title":"Impulsivity across the course of bipolar disorder","volume":"12","author":"Strakowski","year":"2010","journal-title":"Bipolar Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1111\/j.1399-5618.2009.00722.x","article-title":"Remission from mania is associated with a decrease in amygdala activation during motor response inhibition","volume":"11","author":"Kaladjian","year":"2009","journal-title":"Bipolar Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/j.1399-5618.2012.01035.x","article-title":"Trait impulsivity as an endophenotype for bipolar I disorder","volume":"14","author":"Lombardo","year":"2012","journal-title":"Bipolar Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1016\/j.comppsych.2013.05.019","article-title":"A sib-pair analysis of impulsivity in bipolar disorder type I","volume":"54","author":"Nery","year":"2013","journal-title":"Compr. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","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","year":"2020","journal-title":"Psychol. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1002\/1097-4679(199511)51:6<768::AID-JCLP2270510607>3.0.CO;2-1","article-title":"Factor structure of the Barratt Impulsiveness Scale","volume":"51","author":"Patton","year":"1995","journal-title":"J. Clin. Psychol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jad.2007.07.011","article-title":"Impulsivity: Differential relationship to depression and mania in bipolar disorder","volume":"106","author":"Swann","year":"2008","journal-title":"J. Affect. Disord."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/j.biopsych.2005.05.020","article-title":"Evidence for deficit in tasks of ventral, but not dorsal, prefrontal executive function as an endophenotypic marker for bipolar disorder","volume":"58","author":"Frangou","year":"2005","journal-title":"Biol. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ibanez, A., Cetkovich, M., Petroni, A., Urquina, H., Baez, S., Gonzalez-Gadea, M.L., Kamienkowski, J.E., Torralva, T., Torrente, F., and Strejilevich, S. (2012). The neural basis of decision-making and reward processing in adults with euthymic bipolar disorder or attention-deficit\/hyperactivity disorder (ADHD). PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0037306"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/j.1467-9450.2005.00463.x","article-title":"Effects of stop signal modality, stop signal intensity and tracking method on inhibitory performance as determined by use of the stop signal paradigm","volume":"46","author":"Licht","year":"2005","journal-title":"Scand. J. Psychol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.actpsy.2003.12.005","article-title":"Executive function across the life span","volume":"115","author":"Zelazo","year":"2004","journal-title":"Acta Psychol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1017\/S0033291709991644","article-title":"Gender differences in immediate memory in bipolar disorder","volume":"40","author":"Carrus","year":"2010","journal-title":"Psychol. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/j.1399-5618.2008.00658.x","article-title":"Characterizing impulsivity in mania","volume":"11","author":"Strakowski","year":"2009","journal-title":"Bipolar Disord."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1192\/bjp.bp.106.022921","article-title":"Sustained attention and executive functions in euthymic young people with bipolar disorder","volume":"189","author":"Kolur","year":"2006","journal-title":"Br. J. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s12991-015-0080-0","article-title":"Cognitive impairment in manic bipolar patients: Important, understated, significant aspects","volume":"14","author":"Vrabie","year":"2015","journal-title":"Ann. Gen. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.psychres.2013.10.028","article-title":"Reward sensitivity and anger in euthymic bipolar disorder","volume":"215","author":"Duek","year":"2014","journal-title":"Psychiatry Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.neuropharm.2019.03.028","article-title":"Cognitive variability in bipolar I disorder: A cluster-analytic approach informed by resting-state data","volume":"156","author":"Kollmann","year":"2019","journal-title":"Neuropharmacology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.euroneuro.2006.10.002","article-title":"Impulsivity and bipolar disorder","volume":"17","author":"Najt","year":"2007","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/2194-7511-2-2","article-title":"Impulsivity: Present during euthymia in bipolar disorder?\u2014A systematic review","volume":"2","author":"Newman","year":"2014","journal-title":"Int. J. Bipolar Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/j.comppsych.2014.05.010","article-title":"Is impulsivity in remitted bipolar disorder a stable trait? A meta-analytic review","volume":"55","author":"Saddichha","year":"2014","journal-title":"Compr. Psychiatry"},{"key":"ref_26","first-page":"89","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"10","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_27","unstructured":"Kmet, L., Lee, R., and Cook, L. (2004). Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields, Alberta Heritage Foundation for Medical Research."},{"key":"ref_28","unstructured":"(2020). Review Manager [Computer Programme], Cochrane Collaboration."},{"key":"ref_29","unstructured":"(2017). R Core Team R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing."},{"key":"ref_30","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Laurence Erlbaum Associates. [2nd ed.]."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.2307\/2533446","article-title":"Operating characteristics of a rank correlation test for publication bias","volume":"50","author":"Begg","year":"1994","journal-title":"Biometrics"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.neuroimage.2014.04.062","article-title":"Bipolar and borderline patients display differential patterns of functional connectivity among resting state networks","volume":"98","author":"Das","year":"2014","journal-title":"Neuroimage"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"407","DOI":"10.2147\/NDT.S238887","article-title":"Impulsivity, unplanned pregnancies, and contraception among women with bipolar disorder","volume":"16","author":"Eroglu","year":"2020","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jad.2016.03.027","article-title":"Borderline personality disorder, but not euthymic bipolar i disorder, is associated with prolonged post-error slowing in sensorimotor performance","volume":"198","author":"Saunders","year":"2016","journal-title":"J. Affect. Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.bbr.2018.04.015","article-title":"Bipolar affective disorder and borderline personality disorder: Differentiation based on the history of early life stress and psychoneuroendocrine measures","volume":"357\u2013358","author":"Mazer","year":"2019","journal-title":"Behav. Brain Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.eurpsy.2009.03.004","article-title":"Impulsivity, personality and bipolar disorder","volume":"24","author":"Lewis","year":"2009","journal-title":"Eur. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1080\/13546805.2015.1076722","article-title":"Assessing personal financial management in patients with bipolar disorder and its relation to impulsivity and response inhibition","volume":"20","author":"Cheema","year":"2015","journal-title":"Cogn. Neuropsychiatry"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jad.2014.08.056","article-title":"Resilience and impulsivity in euthymic patients with bipolar disorder","volume":"170","author":"Choi","year":"2015","journal-title":"J. Affect. Disord."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1080\/13651501.2020.1833040","article-title":"Relationship between impulsivity, comorbid anxiety and neurocognitive functions in bipolar disorder","volume":"25","author":"Cesur","year":"2021","journal-title":"Int. J. Psychiatry Clin. Pract."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.psychres.2011.06.010","article-title":"relationship of trait impulsivity with clinical presentation in euthymic bipolar disorder patients","volume":"190","author":"Ekinci","year":"2011","journal-title":"Psychiatry Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1111\/bdi.12034","article-title":"Is impulsivity a common trait in bipolar and unipolar disorders?","volume":"15","author":"Henna","year":"2013","journal-title":"Bipolar Disord."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1017\/S1355617713000015","article-title":"Can risk-taking be an endophenotype for bipolar disorder? A study on patients with bipolar disorder type I and Their first-degree relatives","volume":"19","author":"Tunca","year":"2013","journal-title":"J. Int. Neuropsychol. Soc. JINS"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"8","DOI":"10.5455\/jmood.20141203013231","article-title":"Temperament-character features, levels of impulsiveness and functionality in bipolar disorder patients with and without suicide attempts: A controlled study","volume":"5","author":"Izci","year":"2015","journal-title":"J. Mood Disord."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"177","DOI":"10.2147\/NDT.S90596","article-title":"The differences in temperament-character traits, suicide attempts, impulsivity, and functionality levels of patients with bipolar disorder I and II","volume":"12","author":"Izci","year":"2016","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.nicl.2020.102487","article-title":"Altered neural responses to social fairness in bipolar disorder","volume":"28","author":"Lois","year":"2020","journal-title":"NeuroImage Clin."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.jad.2012.05.001","article-title":"Reduced posterior corpus callosum area in suicidal and non-suicidal patients with bipolar disorder","volume":"142","author":"Rocha","year":"2012","journal-title":"J. Affect. Disord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"165180","DOI":"10.1155\/2015\/165180","article-title":"Normal metabolic levels in prefrontal cortex in euthymic bipolar I patients with and without suicide attempts","volume":"2015","author":"Rocha","year":"2015","journal-title":"Neural Plast."},{"key":"ref_48","first-page":"156","article-title":"Impulsivity differences between bipolar and unipolar depression","volume":"61","author":"Ozten","year":"2019","journal-title":"Indian J. Psychiatry"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.jad.2006.09.037","article-title":"Trait impulsivity in patients with mood disorders","volume":"100","author":"Peluso","year":"2007","journal-title":"J. Affect. Disord."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jad.2015.12.019","article-title":"Dysfunctional decision-making related to white matter alterations in bipolar I disorder","volume":"194","author":"Scholz","year":"2016","journal-title":"J. Affect. Disord."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s40345-016-0057-1","article-title":"Behavioral measures and self-report of impulsivity in bipolar disorder: No association between stroop test and Barratt Impulsiveness Scale","volume":"4","author":"Strasser","year":"2016","journal-title":"Int. J. Bipolar Disord."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0165-0327(02)00328-2","article-title":"Impulsivity and phase of illness in bipolar disorder","volume":"73","author":"Swann","year":"2003","journal-title":"J. Affect. Disord."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/j.1399-5618.2009.00678.x","article-title":"Increased trait-like impulsivity and course of illness in bipolar disorder","volume":"11","author":"Swann","year":"2009","journal-title":"Bipolar Disord."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1017\/S0033291716003299","article-title":"Structural correlates of trait impulsivity in patients with bipolar disorder and healthy controls: A surface-based morphometry study","volume":"47","author":"Tu","year":"2017","journal-title":"Psychol. Med."},{"key":"ref_55","first-page":"78","article-title":"The effect of childhood trauma on impulsivity in patients with bipolar disorder","volume":"9","author":"Tunc","year":"2019","journal-title":"Psychiatry Behav. Sci."},{"key":"ref_56","first-page":"113","article-title":"Comparing neurocognitive profile of patients with borderline personality and bipolar\u2014II disorders","volume":"14","author":"Akbari","year":"2019","journal-title":"Iran. J. Psychiatry"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/hup.2510","article-title":"Potential neuroprotective effect of lithium in bipolar patients evaluated by neuropsychological assessment: Preliminary results","volume":"31","author":"Bersani","year":"2016","journal-title":"Hum. Psychopharmacol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1017\/S135561771400112X","article-title":"Increased cerebral blood flow associated with better response inhibition in bipolar disorder","volume":"21","author":"Dev","year":"2015","journal-title":"J. Int. Neuropsychol. Soc."},{"key":"ref_59","first-page":"e209","article-title":"working memory and response inhibition in patients with bipolar I disorder during euthymic period","volume":"9","author":"Farahmand","year":"2015","journal-title":"Iran. J. Psychiatry Behav. Sci."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1016\/j.psychres.2013.09.011","article-title":"Differences in attention and impulsivity between borderline personality disorder and bipolar disorder","volume":"210","author":"Soler","year":"2013","journal-title":"Psychiatry Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/bdi.12335","article-title":"Response inhibition and interference control in patients with bipolar I disorder and first-degree relatives","volume":"17","author":"Torres","year":"2015","journal-title":"Bipolar Disord."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.pscychresns.2008.08.003","article-title":"Reduced brain activation in euthymic bipolar patients during response inhibition: An event-related FMRI study","volume":"173","author":"Kaladjian","year":"2009","journal-title":"Psychiatry Res. Neuroimaging"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jad.2011.03.051","article-title":"The 5-HTTLPR polymorphism, impulsivity and suicide behavior in euthymic bipolar patients","volume":"133","author":"Neves","year":"2011","journal-title":"J. Affect. Disord."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.clinph.2016.12.006","article-title":"Inhibitory control in euthymic bipolar disorder: Event related potentials during a go\/nogo task","volume":"128","author":"Morsel","year":"2017","journal-title":"Clin. Neurophysiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.psychres.2013.06.039","article-title":"Performance monitoring and executive control of attention in euthymic bipolar disorder: Employing the CPT-AX paradigm","volume":"210","author":"Robinson","year":"2013","journal-title":"Psychiatry Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1111\/j.1399-5618.2009.00670.x","article-title":"No differential effect of age on brain matter volume and cognition in bipolar patients and healthy individuals","volume":"11","author":"Sarnicola","year":"2009","journal-title":"Bipolar Disord."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/j.1399-5618.2004.00110.x","article-title":"Impulsivity: A link between bipolar disorder and substance abuse","volume":"6","author":"Swann","year":"2004","journal-title":"Bipolar Disord."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.paid.2009.04.008","article-title":"Fifty years of the Barratt Impulsiveness Scale: An update and review","volume":"47","author":"Stanford","year":"2009","journal-title":"Personal. Individ. Differ."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jad.2015.02.018","article-title":"Increased impulsivity as a vulnerability marker for bipolar disorder: Evidence from self-report and experimental measures in two high-risk populations","volume":"178","author":"Wessa","year":"2015","journal-title":"J. Affect. Disord."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.bbr.2013.12.003","article-title":"Sleep deprivation impairs performance in the 5-choice continuous performance test: Similarities between humans and mice","volume":"261","author":"Acheson","year":"2014","journal-title":"Behav. Brain Res."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/S0893-133X(96)00018-8","article-title":"Nicotine-haloperidol interactions and cognitive performance in schizophrenics","volume":"15","author":"Levin","year":"1996","journal-title":"Neuropsychopharmacology"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.neubiorev.2021.01.017","article-title":"Comorbidity of ADHD and adult bipolar disorder: A systematic review and meta-analysis","volume":"124","author":"Schiweck","year":"2021","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/bdi.12968","article-title":"Cognitive remediation therapy for patients with bipolar disorder: A randomised proof-of-concept trial","volume":"23","author":"Strawbridge","year":"2021","journal-title":"Bipolar Disord."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1037\/0021-843X.109.2.222","article-title":"A longitudinal study of high scorers on the hypomanic personality scale","volume":"109","author":"Kwapil","year":"2000","journal-title":"J. Abnorm. Psychol."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/10\/1351\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:46:59Z","timestamp":1760143619000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/10\/1351"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,5]]},"references-count":74,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["brainsci12101351"],"URL":"https:\/\/doi.org\/10.3390\/brainsci12101351","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,5]]}}}