TY  - JOUR
PY  - 2020//
TI  - Association of anger attacks with suicidal ideation in adults with major depressive disorder: findings from the EMBARC study
JO  - Depression and anxiety
A1  - Jha, Manish Kumar
A1  - Fava, Maurizio
A1  - Minhajuddin, Abu
A1  - Chin Fatt, Cherise
A1  - Mischoulon, David
A1  - Cusin, Christina
A1  - Trivedi, Madhukar H.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: This report evaluates whether anger attacks (sudden uncharacteristic bouts of anger that are associated with autonomic arousal and/or aggression) in patients with major depressive disorder (MDD) are associated with elevated suicidal ideation (SI; active suicidal thoughts and plans).     METHODS: Participants of Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study who completed Massachusetts General Hospital Anger Attack Questionnaire (AAQ) at baseline were included (n = 293). Levels of SI (suicidal thoughts factor of Concise Health Risk Tracking) were compared at baseline with generalized linear models, and during Stage 1 (baseline-to-week-8) and Stage 2 (week-8-to-week-16) with repeated-measures mixed model analyses. Covariates included age, sex, race, ethnicity, site, and treatment arm.     RESULTS: At baseline, participants with (n = 109) versus without anger attacks (n = 184) had higher levels of SI (Cohen's d effect size [d] = 1.20). Those with ≥9 anger attacks in the past month had significantly higher SI than those with 1-2 (d = 1.21), 3-4 (d = 1.48), and 5-8 (d = 0.94) anger attacks in the past month. Furthermore, participants with anger attacks at baseline reported higher SI at each post-baseline visit (both Stages 1 and 2) of EMBARC study (d = 0.39-0.77; all p < .05). Associations between anger attacks and SI were significant even after controlling for irritability, hostility, anxious arousal, depression, suicide propensity, and self-reported pain at baseline and lifetime suicidal tendencies. Similar results were found in participants with aggressive behaviors.     CONCLUSION: Anger attacks in outpatients with MDD may be associated with chronically elevated SI.   Clinical Trials Registration: Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care for Depression (EMBARC); NCT01407094; https://clinicaltrials.gov/ct2/show/NCT01407094.<p />  <p>Language: en</p>
LA  - en
SN  - 1091-4269
UR  - http://dx.doi.org/10.1002/da.23095
ID  - ref1
ER  -