The prevalence and clinical correlates of anger attacks during depressive episodes in bipolar disorder

Background: Anger attacks, characterized by sudden episodes of intense anger with autonomic arousal, have been described in patients with major depressive disorder (MDD). This study compared the prevalence and clinical significance of anger attacks in unipolar versus bipolar depression. Methods: Using the questionnaire of Fava et al. [Psychopharmacol. Bull. 27(3) (1991) 275–279], we assessed rates of anger attacks among outpatients with MDD (n=50) or bipolar disorder (BPD) (n=29) who were currently in a pure depressive episode. Results: Anger attacks were significantly more common among bipolar (62%) than unipolar (26%) depressed individuals. In a multiple logistic regression, the presence of anger attacks emerged as a significant predictor of bipolarity. Limitations: This preliminary finding should be confirmed in a larger sample. Conclusions: These results suggest that anger attacks may be a common feature of bipolar depression.