Parneix Matthieu, Pericaud Marion, Clement Jean-Pierre
Turk Psikiyatri Derg. 2014 Summer;25(2):106-13.
Irritability is a well-known feature of some mood states. Within the framework of major depressive episodes (MDEs) irritability has been associated with subtypes of depressive mood, personality traits, depressive mixed states, and a bipolar diathesis. This study aimed to assess the symptomatology of irritable depression and the effect of personality.
The study included 93 patients with MDEs, with and without other diagnoses. The characteristics and severity of depressive, manic, and anxious symptoms were assessed. Irritability was determined using the Irritability, Depression and Anxiety Scale outwardly directed irritability subscale (IDA-out). The patients were also administered the Multidimensional Assessment of Thymic States and the Irritability Questionnaire. Personality was assessed using the Temperament and Character Inventory-125 (TCI-125) and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-A).
More of the MDE patients with irritability (32.3%) had atypical features (i.e. weight gain and rejection sensitivity), guilt, hypomanic symptoms, depressive mixed states, and a personal and family history of bipolar disorder than the MDE patients without irritability. Irritability was moderately correlated with depression, hypomania, anxiety, and emotional reactivity. More of the irritable MDE patients exhibited increased novelty seeking, irritable and hyperthymic temperament scores, and had lower TCI-125 and TEMPS-A cooperation and harm avoidance scores than those that were not irritable. Forward logistic regression analysis showed that there was a strong independent association between irritability, and weight gain, irritable temperament, depressive mixed states, novelty seeking, and depression.
MDE-related irritability was strongly associated with atypical and mixed features, which may be indicative of a bipolar diathesis, as well as specific temperament characteristics that may be indicative of trait activation.
易激惹是某些情绪状态的一个众所周知的特征。在重度抑郁发作（MDE）的框架内，易激惹与抑郁情绪亚型、人格特质、抑郁混合状态和双相素质有关。本研究旨在评估易激惹性抑郁症的症状学及人格的影响。
该研究纳入了93例患有或未患有其他诊断的MDE患者。评估了抑郁、躁狂和焦虑症状的特征及严重程度。使用易激惹、抑郁和焦虑量表外向性易激惹分量表（IDA-out）来确定易激惹性。还对患者进行了胸腺状态多维评估和易激惹问卷测试。使用气质与性格量表-125（TCI-125）和孟菲斯、比萨、巴黎和圣地亚哥气质评估量表（TEMPS-A）评估人格。
与无易激惹性的MDE患者相比，更多有易激惹性的MDE患者（32.3%）具有非典型特征（即体重增加和拒绝敏感性）、内疚、轻躁狂症状、抑郁混合状态以及双相情感障碍的个人和家族史。易激惹性与抑郁、轻躁狂、焦虑和情绪反应性呈中度相关。与无易激惹性的患者相比，更多有易激惹性的MDE患者表现出更高的新奇寻求、易激惹和情绪高涨气质得分，且TCI-125和TEMPS-A的合作及避免伤害得分更低。向前逻辑回归分析表明，易激惹性与体重增加、易激惹气质、抑郁混合状态、新奇寻求和抑郁之间存在强烈的独立关联。
与MDE相关的易激惹性与非典型和混合特征密切相关，这可能表明存在双相素质，以及可能表明特质激活的特定气质特征。
