Is bipolar disorder specifically associated with aggression?

Abstract

Objective Several studies have suggested that bipolar disorder (BP) in adults is associated with aggressive behaviors. However, most studies have only included inpatients and have not taken possible confounding factors into consideration. The goal of this study was to compare the prevalence of aggression in subjects with BP compared to subjects with other non-BP psychopathology and healthy controls. Methods Subjects with bipolar I disorder (BP-I) and bipolar II disorder (BP-II) (n = 255), non-BP psychopathology (n = 85), and healthy controls (n = 84) were recruited. Aggression was measured using the Aggression Questionnaire (AQ). Group comparisons were adjusted for demographic and clinical differences (e.g., comorbid disorders) and multiple comparisons. The effects of the subtype of BP, current versus past episode, polarity of current episode, psychosis, the presence of irritable mania/hypomania only, and pharmacological treatment were examined. Results Subjects with BP showed significantly higher total and subscale AQ scores (raw and T-scores) when compared with subjects with non-BP psychopathology and healthy controls. Exclusion of subjects with current mood episodes and those with common comorbid disorders yielded similar results. There were no effects of BP subtype, polarity of the current episode, irritable manic/hypomanic episodes only, or current use of pharmacological treatments. Independent of the severity of BP and polarity of the episode, those in a current mood episode showed significantly higher AQ scores than those not in a current mood episode. Subjects with current psychosis showed significantly higher total AQ score, hostility, and anger than those without current psychosis. Conclusions Subjects with BP display greater rates of anger and aggressive behaviors, especially during acute and psychotic episodes. Early identification and management of these behaviors is warranted.

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

“…In comparison with subjects with no-BD, but suffering from other psychiatric disorders, and healthy controls, BD patients showed in previous studies increased selfreported verbal and physical aggressiveness, particularly during acute episodes and independently from BD subtypes, severity and polarity of the current episode, psychotic symptoms and current pharmacological treatments (4,9). In addition, manic patients showed the highest odds ratio for aggressive incidents among psychiatric inpatients (10).…”

“…Particularly, bipolar disorder (BD) patients presented increased risk for aggressive behaviors (4,5). Indeed, aggressiveness has assumed particular importance as a core feature of manic and mixed states (6), independently from psychosis (7), and often emerging as a correlate of comorbid substance abuse and suicidality (8).…”

<em>Toxoplasma gondii</em> Infection

“…59, 60 Our results further add to the biological complexity of impulsive aggression, from both a categorical and a dimensional perspective. It is illegal to post this copyrighted PDF on any website.…”

Aggression in Psychoses

“…Patients experiencing a current mood episode showed significantly higher aggression scores than those not in a mood episode. This effect was independent of the severity of bipolar disorder and polarity of the episode [149].…”

“…Prevalence of aggressive behavior was compared in a sample of 255 individuals with bipolar I and bipolar II disorder, 85 individuals with other psychopathology, and 84 healthy controls [149]. Lifetime aggression was assessed using a questionnaire that was administered by interviewers in the subjects' homes.…”