Department of Psychiatry, University of Geneva, Geneva, Switzerland.
J Affect Disord. 2011 Nov;134(1-3):112-8. doi: 10.1016/j.jad.2011.05.048. Epub 2011 Jul 1.
Predictors of suicidal behaviors (SB) in bipolar (BD) and major depressive disorder (MDD) patients are poorly understood. It has been recognized that behavioral dysregulation characterizes SB with traits of impulsivity and aggression being particularly salient. However, little is known about how these traits are segregated among mood disorder patients with and without a history of suicide attempt (SA).
This article aims to compare impulsivity and aggression between 143 controls, 138 BD and 186 MDD subjects with or without a history of SA.
BD and MDD patients showed higher impulsivity scores (BIS-10 = 57.9 vs. 44.7, p < 0.0001) and more severe lifetime aggression than controls (Lifetime History of Aggression = 7.3 vs. 3.9, p < 0.0001). Whereas impulsivity helped to distinguish MDD subjects without a history of SA from those with such a history, this was not the case in BD subjects where no difference in impulsive traits was observed between BD without and with history of SA (57.2 vs. 63.2 for BIS-10; p = 0.259). Impulsive and aggressive traits were strongly correlated in suicide attempters (independently of the diagnosis) but not in non-suicide attempters.
Dimensional traits were not characterized at different stages of illness.
Impulsivity, as a single trait, may be a reliable suicide risk marker in MDD but not in BD patients, and its strong correlation with aggressive traits seems specifically related to SB. Our study therefore suggests that the specific dimension of impulsive aggression should be systematically assessed in mood disorder patients to address properly their suicidal risk.
双相情感障碍（BD）和重度抑郁症（MDD）患者自杀行为（SB）的预测因素了解甚少。人们已经认识到，行为失调是 SB 的特征，冲动和攻击性特质尤为突出。然而，对于有或没有自杀企图（SA）病史的心境障碍患者中，这些特质是如何分离的，我们知之甚少。
本文旨在比较 143 名对照者、138 名 BD 和 186 名 MDD 患者（有无 SA 病史）之间的冲动性和攻击性。
BD 和 MDD 患者的冲动性评分（BIS-10=57.9 比 44.7，p<0.0001）和终生攻击性评分（Lifetime History of Aggression=7.3 比 3.9，p<0.0001）均高于对照组。而冲动性有助于区分无 SA 病史的 MDD 患者和有 SA 病史的患者，但在 BD 患者中并非如此，BD 无 SA 病史和有 SA 病史的患者之间的冲动特质没有差异（BIS-10 分别为 57.2 和 63.2；p=0.259）。冲动和攻击特质在自杀企图者（独立于诊断）中高度相关，但在非自杀企图者中不相关。
在疾病的不同阶段没有对维度特征进行描述。
冲动性作为单一特征，可能是 MDD 患者可靠的自杀风险标志物，但不是 BD 患者的可靠标志物，其与攻击性特质的强烈相关性似乎与 SB 特别相关。因此，我们的研究表明，应在心境障碍患者中系统评估冲动性攻击的特定维度，以正确评估其自杀风险。
