The influence of impulsivity on the clinical symptoms and therapeutic response in generalized anxiety disorder: the role of comorbid mental disorders

Objective. The aim of the study was to study the influence of impulsivity on the severity of symptoms and the effectiveness of therapy for generalized anxiety disorder (GAD), taking into account the factor of comorbid mental disorders. Materials and methods. The study included 153 patients with GAD, including 36 patients with concomitant mental disorders. Psychometric assessment of symptoms of anxiety and depression was carried out using the Hospital Anxiety and Depression Scale (HADS), symptoms of impulsivity – on the Barratt Impulsivity Scale. The following information was collected about the patients: demographic data, information about psychopharmacotherapy and the effectiveness of treatment. To assess the impact of impulsivity, two groups of patients were compared: with clinically significant impulsivity (total Barratt score above 70) and without it (total Barratt score below 70) in the general group of patients and in a subgroup without comorbid mental disorders that directly affect the level of impulsivity. Results. Increased level of impulsivity is associated with a greater severity of symptoms of anxiety and depression on the HADS scale in the general sample of patients, however, when taking into account the influence of comorbid diagnoses, there was no significant effect of the level of impulsivity on symptoms. Among the individual characteristics of impulsivity, only the association with attention deficit and increased score on the HADS anxiety scale was revealed. Impulsivity had no effect on the effectiveness of therapy. Conclusion. The results of the study show that the symptoms of impulsivity in GAD are largely due to concomitant pathology, whereas in isolated GAD the effect of impulsivity on symptoms is minimal. No significant effect of impulsivity on the therapeutic response was found in this study.

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