Bipolar I and II versus unipolar depression: Clinical differences and impulsivity/aggression traits

Dervic, Kanita; García-Amador, M.; Sudol, Katherin; Freed, Peter; Brent, David A.; Mann, J. John; Harkavy‐Friedman, Jill; Oquendo, María A.

doi:10.1016/j.eurpsy.2014.06.005

Cited by 51 publications

(33 citation statements)

References 96 publications

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“…This is in line with the results of previous findings supporting the quite frequent association between aggressiveness and BD (11,(30)(31)(32).…”

Section: Discussionsupporting

confidence: 83%

“…First, significantly higher frequencies of BD diagnosis were found in depressed patients with aggressiveness, whilst a diagnosis of unipolar depression was negatively correlated with aggressive behaviors. This is consistent with previous reports of a higher association between aggressiveness and BD depression compared to unipolar depression (11). The MDE-A group showed higher rates of family history for BD as well as younger age at the first depressive episode, which represent the most relevant clinical indicators of unrecognized bipolarity in depressed patients (27,(34)(35)(36).…”

Section: Discussionsupporting

confidence: 81%

“…As for trait characteristics of depressive episodes, it has been found that BD-I and BD-II depressed patients had more life-time aggressiveness/hostility than unipolar depressed patients (11).…”

Section: Introductionmentioning

confidence: 99%

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Aggressiveness in depression: a neglected symptom possibly associated with bipolarity and mixed features

Verdolini

Perugi

Samalin

et al. 2017

Acta Psychiatr Scand

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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 2,811 individuals were enrolled in this multicenter cross-sectional study. MDE patients with (MDE-A, n=399) and without aggressiveness (MDE-N, n=2,412) 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) whilst 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.Keys words: aggressiveness, bipolar disorder, DSM-5 mixed features specifier, major depressive episode 3 Significant outcomesIn this post-hoc analysis of the BRIDGE-II-MIX study, the presence of aggressive behaviors was mainly related with socio-demographic and clinical characteristics associated with bipolarity.

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“…This is in line with the results of previous findings supporting the quite frequent association between aggressiveness and BD (11,(30)(31)(32).…”

Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Aggressiveness in depression: a neglected symptom possibly associated with bipolarity and mixed features

Verdolini

Perugi

Samalin

et al. 2017

Acta Psychiatr Scand

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“…In addition, the study did not use self-report psychometric instruments to assess loss aversion, impulsive personality traits and risk tendencies in the two groups; this limits the capacity to rule out the possible confounding effects of these traits on BART performance. Given the relationship between impulsivity and depression among clinical populations (Jakubczyk et al, 2012; Dervic et al, 2014) future research should include such measures.…”

Section: Discussionmentioning

confidence: 99%

Clinical Depression and Punishment Sensitivity on the BART

et al. 2017

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Depression is associated with altered sensitivity to reward and punishment, which can influence complex decision-making. We examined punishment sensitivity in the performance of participants with major depressive disorder (MDD) with that of a comparison group on the automatic Balloon Analogue Risk Task (BART), which is a direct measure of risk taking. The present study examined the BART performance of 30 individuals with MDD and 30 matched comparison individuals. The comparison group (M = 63.25) entered a significantly (p < 0.001; d = 1.1) higher number of pumps on the BART than the MDD group (M = 50.83). Higher levels of depression symptoms were significantly correlated (r = -0.40, p < 0.05) with entering a lower number of pumps in the MDD group. MDD patients showed an increased sensitivity to punishment on the BART: after a loss, the MDD group decreased (M = 13.7) the number of subsequent pumps they entered by a significantly (p < 0.001, d = 0.81) greater amount than the comparison group (M = 4.35). This difference applied to losses only: no difference was found between the groups regarding the magnitude of change in pumps selected after a win. Findings suggest the presence of elevated punishment sensitivity among individuals with MDD, which may contribute to the maintenance of depressive symptoms.

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“…For example, individuals with BSDs score significantly higher on self-report trait measures of aggression (including aggressive behavior, anger, and hostility) compared to healthy controls and to individuals with non-BSD psychopathology (Ballester et al, 2014; Dervic et al, 2015; Molz et al, 2013). Additionally, individuals with BSDs report more extensive histories of lifetime aggressive behaviors in adolescence and adulthood (Corrigan & Watson, 2005; Perroud, Baud, Mouthon, Courtet, & Malafosse, 2011), and inpatients with BSDs are almost three times more likely to display aggressive behavior while in treatment compared to inpatients with other psychiatric disorders (Barlow, Grenyer, & Ilkiw-Lavalle, 2000).…”

mentioning

confidence: 99%

Aggression Protects Against the Onset of Major Depressive Episodes in Individuals With Bipolar Spectrum Disorder

Freed

Titone

et al. 2017

Behavior Therapy

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A growing body of research suggests that bipolar spectrum disorders (BSDs) are associated with high aggression. However, little research has prospectively examined how aggression may affect time to onset of hypomanic/manic versus major depressive episodes. In a longitudinal study, we tested the hypothesis that aggression would prospectively predict a shorter time to the onset of hypomanic/manic episodes and a longer time to the onset of major depressive episodes, based on the Behavioral Approach System theory of BSDs. Young adults (N = 120) diagnosed with cyclothymia, bipolar II disorder, or bipolar disorder not otherwise specified were followed every four months for an average of 3.55 years. Participants completed measures of depressive and manic symptoms, family history of mood disorder, impulsivity, and aggression at baseline and were followed prospectively with semistructured diagnostic interview assessments of hypomanic/manic and major depressive episodes and treatment seeking for mood problems. Cox proportional hazard regression analyses indicated that overall, physical, and verbal aggression predicted a longer time to major depressive episode onset, even after controlling for baseline depressive and manic symptoms, family history of mood disorder, treatment seeking for mood problems, and impulsivity. Aggression, however, did not significantly predict time to onset of hypomanic/manic episodes, controlling for the same covariates. The findings suggest that approach-related behaviors may be utilized to delay the onset of major depressive episodes among people with BSDs.

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Bipolar I and II versus unipolar depression: Clinical differences and impulsivity/aggression traits

Cited by 51 publications

References 96 publications

Aggressiveness in depression: a neglected symptom possibly associated with bipolarity and mixed features

Aggressiveness in depression: a neglected symptom possibly associated with bipolarity and mixed features

Clinical Depression and Punishment Sensitivity on the BART

Aggression Protects Against the Onset of Major Depressive Episodes in Individuals With Bipolar Spectrum Disorder

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