Behavioral and Emotional Disturbances in the Offspring of Depressed Parents with Anger Attacks

Alpert, Jonathan E.; Petersen, Timothy; Roffi, Pamela A.; Papakostas, George I.; Freed, Rachel D.; Smith, Megan M.; Spector, Andrew R.; Nierenberg, Andrew A.; Rosenbaum, Jerrold F.; Fava, Maurizio

doi:10.1159/000068682

Cited by 20 publications

(15 citation statements)

References 13 publications

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“…Mean retrospectively reported age-of-onset of MDD is significantly earlier for irritable than non-irritable MDD. Although the shape of the age-of-onset (AOO) distribution is nonetheless generally consistent for the two sub-types, the earlier onset of irritable than non-irritable MDD is consistent with the one, small clinical study of which we are aware that examined this issue 30. It is unlikely that this is due to differential recall bias, as post hoc analysis shows that the same finding holds when we compare AOO of irritable and non-irritable MDD in sub-samples that are matched on age at interview.…”

Section: Discussionsupporting

confidence: 57%

The importance of irritability as a symptom of major depressive disorder: results from the National Comorbidity Survey Replication

et al. 2009

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Irritability is a diagnostic symptom of child-adolescent but not adult major depressive disorder (MDD) in both the DSM-IV and ICD-10 systems. We explore the importance of irritability for sub-typing adult DSM-IV MDD in the National Comorbidity Survey Replication (NCS-R), a national US adult household survey. The WHO Composite International Diagnostic Interview (CIDI) was used to assess prevalence of many DSM-IV disorders in the lifetime and in the year before interview (12-month prevalence). MDD was assessed conventionally (i.e., requiring either persistent sadness or loss of interest), but with irritability included as one of the Criterion A symptoms. We also considered the possibility that irritability might be a diagnostic symptom of adult MDD (i.e., detect cases who had neither sad mood nor loss of interest). Twelve-month MDD symptom severity was assessed with the Quick Inventory of Depressive Symptomatology and role impairment with the Sheehan Disability Scale. After excluding bipolar spectrum disorders, irritability during depressive episodes was reported by roughly half of respondents with lifetime DSM-IV MDD. Irritability in the absence of either sad mood or loss of interest, in comparison, was rare. Irritability in MDD was associated with early age-of-onset, lifetime persistence, comorbidity with anxiety and impulse-control disorders, fatigue and self-reproach during episodes, and disability. Irritability was especially common in MDD among respondents in the age range 18–44 and students. Further investigation is warranted of distinct family aggregation, risk factors, and treatment response. Consideration should also be given to including irritability as a non-diagnostic symptom of adult MDD in DSM-V and ICD-11.

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Section: Discussionsupporting

confidence: 57%

The importance of irritability as a symptom of major depressive disorder: results from the National Comorbidity Survey Replication

et al. 2009

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“…The frequent masking of irritability and dysphoric affect during the diagnostic interview should also be taken into account [33]. Anger attacks can only rarely be observed when talking to the patient and are more commonly expressed towards members of the immediate family [34]. The Anger Attacks Questionnaire [19] has often been used to diagnose anger attacks.…”

Section: Diagnosis Of the Male Depressive Syndromementioning

confidence: 99%

Gender-specific symptoms of depression and anger attacks

Winkler¹,

Pjrek²,

KasperSiegfried³

2006

The Journal of Men's Health & Gender

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Depression is a serious and potentially life-threatening mental illness, which does not only lead to personal suffering but also impairs social functioning and has a significant socioeconomic effect. Epidemiological studies have found a life-time prevalence of up to 17% in the general population and death due to suicides of up to 15%. As women have a two-fold higher prevalence for depressive disorder, it is noteworthy that suicide rates are consistently higher for men. Previous studies have suggested that mainly men suffer from a specific irritable depressive syndrome, which is characterized by lowered impulse control, symptomatic substance abuse, an increased readiness to take risks, and anger attacks, which present as sudden spells of inappropriate anger with vegetative hyperarousal. This article reviews gender-specific aspects of depressive disorder focussing on anger attacks and their clinical management.

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“…Around 40% of depressed outpatients had one or more anger attacks during the past month [8, 9]. In comparison with depressed patients without anger attacks, these patients had higher levels of hostility, anxiety, somatization [9], higher cholesterol levels [10], more axis II psychopathology [11], increased risk of cardiac dysfunction [12], and a younger age of depression onset [13]. Depressed patients with anger attacks also showed a blunted response to the serotonin (5-HT) agonist fenfluramine [14].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Physiological Correlates of Irritability in Depression: Results from the Netherlands Study of Depression and Anxiety

Verhoeven

Booij

Wee

et al. 2011

Depression Research and Treatment

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Objective. Irritable and nonirritable depressed patients differ on demographic and clinical characteristics. We investigated whether this extends to psychological and physiological measures. Method. We compared irritable and nonirritable unipolar depressed patients on symptomatology, personality, and (psycho)physiological measures (cortisol, cholesterol, and heart rate variability). Symptomatology was reassessed after one year, and we also compared depressed patients who were irritable or non-irritable at both time points (Irr++ versus Irr−−). Results. Almost half (46%; N = 420) of the sample was classified as irritable. These patients scored higher on depression severity, anxiety, hypomanic symptoms, and psychological variables. No differences were observed on physiological markers after correction for depression severity. The same pattern was found when comparing Irr++ and Irr−− groups. Conclusion. Irritable and non-irritable depressed patients differ on clinical and psychological variables, but not on the currently investigated physiological markers. The clinical relevance of the distinction and the significance of the hypomanic symptoms remain to be demonstrated.

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Behavioral and Emotional Disturbances in the Offspring of Depressed Parents with Anger Attacks

Cited by 20 publications

References 13 publications

The importance of irritability as a symptom of major depressive disorder: results from the National Comorbidity Survey Replication

The importance of irritability as a symptom of major depressive disorder: results from the National Comorbidity Survey Replication

Gender-specific symptoms of depression and anger attacks

Clinical and Physiological Correlates of Irritability in Depression: Results from the Netherlands Study of Depression and Anxiety

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