The Principal Dimensions of Manifest Depression

Pull, Charles; Pichot, P; Pull, M. C.; Frenckell, R. von

doi:10.1159/000117684

Cited by 10 publications

(2 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Psychopathologists have also underscored that nonmelancholic depressions often entail anger, and that even during melancholic phases anger can emerge as an antidote against affective anesthesia characterized by the painful feeling of having no feelings [27]. Indeed, a close inspection of the psychiatric literature reveals that symptoms of anger, irritability, aggressiveness and hostility have indeed been observed in patients with depression, when the assessment has been performed with instruments exploring such symptoms [8, 9, 11, 28, 29, 30, 31]. Recently, it has been shown that when assessment instruments covering anger and irritability are used, these symptoms can be easily detected in many psychiatric disorders, particularly in depressed outpatients [2, 10, 32].…”

Section: Discussionmentioning

confidence: 99%

Relevance of Anger and Irritability in Outpatients with Major Depressive Disorder

Pasquini

Picardi²,

Biondi

et al. 2004

Psychopathology

View full text Add to dashboard Cite

Introduction: Current psychiatric classification systems underestimate the part played by anger and aggressiveness in unipolar depression. This study was designed to assess the relevance of anger, irritability, aggressiveness, hostility, and psychomotor activation in major depressive disorder. Methods: A total of 222 newly admitted consecutive outpatients with major depressive disorder (mean age 48.9 years, 64.4% females) were enrolled in the study. They had no comorbid axis I or II DSM-IV disorder, and they received no treatment with antidepressants in the preceding 2 months. They were assessed with the SVARAD, a validated scale for the rapid assessment of the main psychopathological dimensions. Principal component analysis was performed on SVARAD items. Results: We obtained a three-factor solution accounting for 47.4% of total variance. The factors were interpreted as ‘anger/irritability’, ‘depression’, and ‘anxiety’, respectively. The anger/irritability dimension was clinically relevant in 23% of patients. Anger/aggressiveness was especially frequent (21.6%), whereas psychomotor activation was infrequent (0.9%). Discussion: In depressive disorders, there are psychopathological dimensions other than depressed mood and anxiety that deserve greater clinical recognition and research. Our study suggests that one of these symptom clusters includes anger, irritability, aggressiveness, and hostility. The relevance of this dimension was not related to concurrent pharmacological treatment. Misdiagnosis of bipolar II disorder is also unlikely to explain our findings. Possibly, personality factors might at least partly explain the occurrence of anger and aggressiveness in several depressed patients. Attachment theory suggests that anger might also be conceived as part of the protest-despair-detachment reaction to a loss, either actual or symbolic.

show abstract

Section: Discussionmentioning

confidence: 99%

Relevance of Anger and Irritability in Outpatients with Major Depressive Disorder

Pasquini

Picardi²,

Biondi

et al. 2004

Psychopathology

View full text Add to dashboard Cite

show abstract

“…This might partly be ascribed to the use of specific rating scales for depression, which tend to put all depressions 'in the same basket'[2] and have been the object of some criticisms [3-6]. More recently, the use of comprehensive psychopathological rating scales exploring a wide range of symptoms has enabled several researchers to document substantial levels of anger, irritability, hostility and aggressiveness in a sizable portion of patients with unipolar depression [7-10]. Indeed, anger and aggression are prominent in depressed patients to a degree that may rival that of depression and anxiety [11], and anger is higher among patients with depression compared with patients with anxiety or somatoform disorders [12,13].…”

Section: Introductionmentioning

confidence: 99%

Untitled

Pasquini¹,

Picardi²,

Speca³

et al. 2007

Clin Pract Epidemiol Ment Health

View full text Add to dashboard Cite

BackgroundSeveral patients with unipolar depression present with prominent dysphoric mood. We aimed at examining the effectiveness of the combination of an SSRI with an anticonvulsant in such patients.MethodsThirty-five newly admitted outpatients with substantial anger, irritability, aggressiveness or hostility who were diagnosed a DSM-IV unipolar depressive disorder were rated on the Hamilton Depression Rating Scale (HDRS), the Clinical Global Improvement (CGI) scale, and a scale for the rapid dimensional assessment (SVARAD), were prescribed an SSRI and an anticonvulsant (usually valproate), and were followed up for 12 weeks. Repeated measures analysis of variance was used to test for within-subject changes in scale scores over time.ResultsThirty-two and 23 patients attended the follow-up visits 4 and 12 weeks later, respectively. Significant decreases (p < .001) were observed in HDRS total score, HDRS and SVARAD anxiety factors, HDRS and SVARAD core depression factors, and SVARAD anger/irritability factor. Adjusting for age or gender did not change the results. Most patients (82%) were rated as improved or much improved on the CGI.ConclusionAlthough our study has several limitations, we observed a remarkable improvement in most unipolar depressed outpatients with dysphoric mood treated with an SSRI and an anticonvulsant. The effectiveness of anticonvulsants might be linked to their action on symptoms of aggression and behavioural activation.

show abstract

The “Outer Dimensions”: Impulsivity, Anger/Aggressiveness, Activation

Bersani

Pasquini

2018

Dimensional Psychopathology

View full text Add to dashboard Cite

The Principal Dimensions of Manifest Depression

Cited by 10 publications

References 3 publications

Relevance of Anger and Irritability in Outpatients with Major Depressive Disorder

Relevance of Anger and Irritability in Outpatients with Major Depressive Disorder

Untitled

The “Outer Dimensions”: Impulsivity, Anger/Aggressiveness, Activation

Contact Info

Product

Resources

About