Overlapping Spectrum of Impulsivity and Compulsivity Across Psychiatric Disorders: A Narrative Review on Dimensional Perspectives

Impulsivity and compulsivity are complex constructs that underpin a wide range of psychiatric disorders. While traditionally viewed as opposing dimensions, emerging evidence suggests they exist on an overlapping spectrum, influencing diagnosis and treatment. Impulsivity is characterized by poorly planned, premature responses aimed at achieving gratification, while compulsivity involves repetitive behaviors driven by anxiety relief. Both constructs share common neurobiological substrates, such as impaired response inhibition and urgency, but differ in their executive dysfunction patterns. Psychiatric disorders traditionally associated with impulsivity (e.g., attention-deficit hyperactivity disorder, bipolar disorder) and those aligned with compulsivity (e.g., obsessive-compulsive disorder, anorexia nervosa) often exhibit overlapping symptoms. Additionally, the same disorder may present varying levels of impulsivity and compulsivity across individuals and time points. The impulsivity-compulsivity spectrum offers a dimensional framework for understanding psychiatric disorders, emphasizing the need for individualized clinical approaches. This review aims to highlight the shared and distinct features, as well as the neurobiological pathways, associated with this spectrum, while underscoring the need for future research to refine dimensional models that enhance diagnostic accuracy and guide personalized interventions.