Premium
Aggressiveness in depression: a neglected symptom possibly associated with bipolarity and mixed features
Author(s) -
Verdolini N.,
Perugi G.,
Samalin L.,
Murru A.,
Angst J.,
Azorin J.M.,
Bowden C. L.,
Mosolov S.,
Young A. H.,
Barbuti M.,
Guiso G.,
Popovic D.,
Vieta E.,
Pacchiarotti I.
Publication year - 2017
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12777
Subject(s) - major depressive episode , bipolar disorder , logistic regression , depression (economics) , mania , psychology , psychiatry , substance abuse , post hoc analysis , borderline personality disorder , major depressive disorder , medicine , clinical psychology , cognition , economics , macroeconomics
Objective To evaluate aggressiveness during a major depressive episode ( MDE ) and its relationship with bipolar disorder ( BD ) in a post hoc analysis of the BRIDGE ‐ II ‐ MIX study. Method A total of 2811 individuals were enrolled in this multicenter cross‐sectional study. MDE patients with ( MDE ‐A, n = 399) and without aggressiveness ( MDE ‐N, n = 2412) were compared through chi‐square test or Student's t ‐test. A stepwise backward logistic regression model was performed. Results MDE ‐A group was more frequently associated with BD ( P < 0.001), while aggressiveness was negatively correlated with unipolar depression ( P < 0.001). At the logistic regression, aggressiveness was associated with the age at first depressive episode ( P < 0.001); the severity of mania ( P = 0.03); the diagnosis of BD ( P = 0.001); comorbid borderline personality disorder ( BPD ) ( P < 0.001) but not substance abuse ( P = 0.63); no current psychiatric treatment ( P < 0.001); psychotic symptoms ( P = 0.007); the marked social/occupational impairment ( P = 0.002). The variable most significantly associated with aggressiveness was the presence of DSM ‐5 mixed features ( P < 0.001, OR = 3.815). After the exclusion of BPD , the variable of lifetime suicide attempts became significant ( P = 0.013, OR = 1.405). Conclusion Aggressiveness seems to be significantly associated with bipolar spectrum disorders, independently from BPD and substance abuse. Aggressiveness should be considered as a diagnostic criterion for the mixed features specifier and a target of tailored treatment strategy.