@article{ref1,
title="Aggressiveness in depression: a neglected symptom possibly associated with bipolarity and mixed features",
journal="Acta psychiatrica Scandinavica",
year="2017",
author="Verdolini, N. and Perugi, G. and Samalin, L. and Murru, A. and Angst, J. and Azorin, J-M and Bowden, C. L. and Mosolov, S. and Young, A. H. and Barbuti, M. and Guiso, G. and Popović, D. and Vieta, E. and Pacchiarotti, I.",
volume="136",
number="4",
pages="362-372",
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. <br><br>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. <br><br>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). <br><br>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.<br><br>© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.<p /> <p>Language: en</p>",
language="en",
issn="0001-690X",
doi="10.1111/acps.12777",
url="http://dx.doi.org/10.1111/acps.12777"
}