Clinical Characteristics and Aggression in Unipolar and Bipolar Course of Affective Disorders

TL;DR

This study compares clinical features and aggression levels in patients with unipolar and bipolar depression, finding no significant differences in aggression patterns.

Contribution

The study contributes by analyzing aggression levels in unipolar and bipolar depression using standardized psychometric tools.

Findings

Patients with bipolar depression were older and had shorter depressive episodes compared to those with unipolar depression.

No statistically significant correlations were found between aggression levels and depression types.

The study did not identify unique clinical patterns distinguishing unipolar from bipolar depression.

Abstract

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.

To identify clinical characteristics of unipolar and bipolar depressive disorders and assess their correlation with aggression levels in patients.

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.

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 admission19 (15.5; 24)22 (18; 26)0.044
HAM-D after 3 weeks4 (2; 6)4 (3; 7.75)0.219HAM-A on admission16 (12; 25)19.5 (13; 26.75)0.098HAM-A after 3 weeks3 (2; 6.5)4 (3; 7.75)0.219SHAPS on admission5 (1.25; 9)3 (0; 10)0.7SHAPS after 3 weeks1 (0; 4)1 (0; 3)0.44

Clinical Characteristics of Unipolar and Bipolar Depression Course

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 index19 (13; 24)18.5 (12; 24)0.745Hostility index9 (7; 13.75)9 (7; 11)0.139Assault Hostility4 (2; 6)4 (2; 6)0.618Indirect Hostility5 (5; 6)4 (4; 6)0.015
Irritability6 (4; 8)5 (3; 7)0.081Negativism2 (1; 4)2 (1; 4)0.262Resentment5 (4; 6)5 (3; 6)0.113Verbal Hostility7 (6; 8)6 (5; 8)0.008

The severity of aggressiveness in unipolar and bipolar depression.

As a result of the study, no statistically significant correlations were found (p>0.05, Spearman’s test).

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.

None Declared

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