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Clinical Characteristics and Aggression in Unipolar and Bipolar Course of Affective Disorders
Published online by Cambridge University Press: 27 August 2024
Abstract
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Introduction
The diagnosis and treatment of depression are complex due to its diverse forms. Recent focus in clinical practice has been on identifying markers for mono- and bipolar depression, as early diagnosis significantly impacts treatment.
Objectives
To identify clinical characteristics of unipolar and bipolar depressive disorders and assess their correlation with aggression levels in patients.
Methods
We studied patients at the Mental Health Research Institute of Tomsk NRMC: ICD-10 codes: Bipolar Affective Disorder (BD) (n=28), Recurrent Depressive Disorder (RDD) (n=33). Patients with BD were older (49 (33; 52) years) than those RDD (40 (31; 51) years) (p=0.018). The current depressive episode duration was shorter for BD (3 (2; 7) months) compared to RDD (5 (2; 12) months) (p=0.018). Gender distribution was comparable (p=0.568). We measured clinical symptoms (depression, anxiety, anhedonia) using psychometric tools (HAM-D, HAM-A, SHAPS) at admission and after 3 weeks of therapy. Aggression was assessed with the Buss-Durkee Hostility Inventory (BDHI) at admission.
Results
Patients with RDD demonstrated a higher severity of depressive symptoms upon admission (Table 1).Table 1.
Clinical Characteristics of Unipolar and Bipolar Depression Course
| Severity of Symptoms | Bipolar Depression | Unipolar Depression | р (U-test) |
|---|---|---|---|
| HAM-D on admission | 19 (15.5; 24) | 22 (18; 26) | 0.044 |
| HAM-D after 3 weeks | 4 (2; 6) | 4 (3; 7.75) | 0.219 |
| HAM-A on admission | 16 (12; 25) | 19.5 (13; 26.75) | 0.098 |
| HAM-A after 3 weeks | 3 (2; 6.5) | 4 (3; 7.75) | 0.219 |
| SHAPS on admission | 5 (1.25; 9) | 3 (0; 10) | 0.7 |
| SHAPS after 3 weeks | 1 (0; 4) | 1 (0; 3) | 0.44 |
The severity of some aggressive patterns was higher in patients with bipolar disorder (Table 2).Table 2.
The severity of aggressiveness in unipolar and bipolar depression.
| BDHI subscale | Bipolar Depression | Unipolar Depression | р (U-test) |
|---|---|---|---|
| Aggressiveness index | 19 (13; 24) | 18.5 (12; 24) | 0.745 |
| Hostility index | 9 (7; 13.75) | 9 (7; 11) | 0.139 |
| Assault Hostility | 4 (2; 6) | 4 (2; 6) | 0.618 |
| Indirect Hostility | 5 (5; 6) | 4 (4; 6) | 0.015 |
| Irritability | 6 (4; 8) | 5 (3; 7) | 0.081 |
| Negativism | 2 (1; 4) | 2 (1; 4) | 0.262 |
| Resentment | 5 (4; 6) | 5 (3; 6) | 0.113 |
| Verbal Hostility | 7 (6; 8) | 6 (5; 8) | 0.008 |
As a result of the study, no statistically significant correlations were found (p>0.05, Spearman’s test).
Conclusions
The conducted research did not yield convincing data that would allow us to make judgments about specific clinical patterns in the course of unipolar and bipolar depression. Thus, the problem of searching for unique biological markers of the courses of affective disorders remains relevant. Support by the Russian Science Foundation grant No. 23-75-00023.
Disclosure of Interest
None Declared
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- European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S431 - S432
- Creative Commons
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.- Copyright
- © The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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