Impulsivity, aggression and suicidal behavior in unipolar and bipolar disorders

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Science

Background:

• Predictors of suicidal behaviors (SB) in bipolar disorder (BD) and major depressive disorder (MDD) are not well understood.
• Behavioral dysregulation, impulsivity, and aggression characterize SB.
• Limited knowledge exists on how these traits differ in mood disorder patients with or without a history of suicide attempt (SA).

Purpose of the Study:

• To compare impulsivity and aggression levels between controls and patients with BD or MDD.
• To investigate the role of impulsivity and aggression in distinguishing between patients with and without a history of SA.
• To explore the correlation between impulsive and aggressive traits in relation to SA history across diagnoses.

Main Methods:

• Cross-sectional study comparing 143 controls, 138 BD subjects, and 186 MDD subjects.
• Assessment of impulsivity using the Barratt Impulsiveness Scale (BIS-10).
• Evaluation of lifetime aggression using the Lifetime History of Aggression scale.

Main Results:

• BD and MDD patients exhibited significantly higher impulsivity and aggression than controls.
• Impulsivity differentiated MDD patients with and without SA history, but not BD patients.
• Impulsive and aggressive traits strongly correlated in suicide attempters, irrespective of diagnosis, but not in non-attempters.

Conclusions:

• Impulsivity may serve as a suicide risk marker in MDD, but not reliably in BD.
• The correlation between impulsivity and aggression is specifically associated with suicidal behaviors.
• Systematic assessment of impulsive aggression is recommended for managing suicidal risk in mood disorder patients.