The Relationship of Impulsivity and Somatoform Dissociation with Aggression in Euthymic Bipolar Disorder

Background: Although aggression in bipolar disorder (BD) is more common during manic episodes, it may also occur during remission. This study examined the associations of impulsivity and somatoform dissociation with aggression and its subdimensions in euthymic patients with BD. Methods: The study included 67 patients diagnosed with BD type I according to DSM-5 criteria who had been in a euthymic state for at least two months. Participants completed a sociodemographic data form, the Barratt Impulsiveness Scale-11, the Somatoform Dissociation Questionnaire, and the Buss-Perry Aggression Questionnaire. Data were analyzed using correlation analysis, multiple linear regression, and hierarchical regression analyses. Statistical significance was set at P < .05. Results: Correlation analyses showed that somatoform dissociation was positively associated with total aggression (r = 0.28, P = .024) and hostility (r = 0.27, P = .025). While total impulsivity was not associated with total aggression, weak positive correlations were found with anger (P = .026). In regression analyses, somatoform dissociation significantly predicted total aggression (β = 0.30, P = .018), verbal aggression (β = 0.33, P = .011), and hostility (β = 0.29, P = .025). Impulsivity was not identified as an independent predictor, whereas somatoform dissociation significantly increased explained variance in hierarchical regression analyses (ΔR² = 0.08, P = .018). Given the exploratory nature of the analyses and the absence of correction for multiple comparisons, these findings should be interpreted cautiously. Conclusion: In euthymic patients with BD, aggression appears to be more consistently associated with somatoform dissociation than with impulsivity. Dissociative symptoms, particularly in relation to verbal aggression and hostility, may represent clinically relevant domains for further assessment.