To summarize, impulsivity, involving poorly regulated action, is pervasive in bipolar disorder and may be one of the basic mechanisms of the illness. It has a state-dependent component that correlates differentially with depressive or manic symptoms. This is superimposed on trait-like features that include the integrated impulsivity reflected in total scores of the BIS-11, problems with response inhibition, and problems with tolerating delays before responding for rewards. There is also some evidence that these features of the disorder involve increased sensitivity to catecholamine activity.
