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

Abstract

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