Anger attacks in bipolar versus recurrent depression

Research on anger attacks has been mostly limited to unipolar depression, and only a few studies have focused on anger attacks in bipolar depression.

In a cross-sectional study, 22 subjects with bipolar depression were compared to 22 subjects with recurrent unipolar depression using an anger attack questionnaire, irritability, depression and anxiety scale and quality of life scale.

Anger attacks were present in 62.5% subjects with recurrent depression (RDD group) compared to 54.5% in subjects with bipolar depression (BD group), but the difference between the groups was not statistically significant. Also, there was no significant difference between the RDD and BD groups on the Irritability Depression and Anxiety Scale and WHOQOL-Bref except that the BD group had a poorer quality of life (QOL) compared to the RDD group in the social relationship domain (t=-2.30, p<0.05). In the BD group, the subjects with anger attacks were older (t=2.77, p<0.05), had significantly higher scores on the Irritability-Outwards component of IDA (t=3.90, p<0.01) and shorter duration of illness (Mann Whitney Signed ranked value 20.00, p<0.01) and duration of treatment (Mann Whitney Signed ranked value 28.00, p<0.05) compared to BD group members without anger attacks. In the RDD group, the subjects with anger attacks had poor QOL in the social domain (t= -2.12, p<0.05), environmental domain (t=2.99, p=.01) and total (t=2.56, p<0.05) QOL compared to those without anger attacks.

Anger attacks are equally prevalent in unipolar and bipolar depression, are not influenced by sociodemographic and clinical variables, and lead to comparable impact on the subjective QOL in both groups.