N Verdolini1,2, G Perugi3, L Samalin1,4,5, A Murru1, J Angst6, J-M Azorin7, C L Bowden8, S Mosolov9, A H Young10, M Barbuti1,3, G Guiso1,11, D Popovic1,12, E Vieta1, I Pacchiarotti1. 1. Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. 2. Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy. 3. Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy. 4. Department of Psychiatry, CHU Clermont-Ferrand, University of Auvergne, EA 7280, Clermont-Ferrand, France. 5. Fondation FondaMental, Hôpital Albert Chenevier, Pôle de Psychiatrie, Créteil, France. 6. Psychiatric Hospital, University of Zurich, Zurich, Switzerland. 7. AP HM, Psychiatric Pole, Sainte Marguerite, Marseille, France. 8. Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA. 9. Department for Therapy of Mental Disorders, Moscow Research Institute of Psychiatry, Moscow, Russia. 10. Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. 11. Department of Medical Sciences and Public Health, University of Cagliari and Psychiatric Clinic, University Hospital, Cagliari, Italy. 12. Psychiatry B, The Chaim Sheba Medical Center, Ramat-Gan, Israel.
Abstract
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.
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.
Authors: Vincenzo Oliva; Michele De Prisco; Maria Teresa Pons-Cabrera; Pablo Guzmán; Gerard Anmella; Diego Hidalgo-Mazzei; Iria Grande; Giuseppe Fanelli; Chiara Fabbri; Alessandro Serretti; Michele Fornaro; Felice Iasevoli; Andrea de Bartolomeis; Andrea Murru; Eduard Vieta; Giovanna Fico Journal: J Clin Med Date: 2022-07-06 Impact factor: 4.964