These behaviors are viewed as pathological when they become intrusive, otherwise disrupt normal life routines, cause clinical distress or lead to harmful behaviors directed at oneself or others16, possibly at the point where there is a failure in the inhibitory self-control mechanisms that are called upon to interrupt or suppress these behaviors.1, 17, 18 Pathological impulsive behaviors are either diagnostic of, or are common sequelae of, a range of psychiatric disorders, including the so-called impulse control disorders, attention deficit/hyperactivity and conduct disorders,19–24 bipolar (manic-depressive) disorder,25 borderline personality disorder26, 27 and (of most relevance to this review) substance-use disorders.22, 23, 28–33 Impulsivity also appears to be a significant major contributor to suicidality in patients with these disorders.34
