(HealthDay News) – For patients with unipolar major depressive episodes (MDEs), overt irritability/anger correlates with more severe, chronic, and complex disease, according to a study published online Sept. 11 in JAMA Psychiatry.

Lewis L. Judd, MD, from the University of California in San Diego, and colleagues examined the prevalence of overtly expressed irritability/anger and its effect on intake presentation and the long-term course of illness in a cohort of 536 patients with unipolar MDEs at intake. Patients were divided into those with (54.5%) and without current comorbid overtly expressed irritability/anger, and were followed for 31 years.

The researchers found that overt irritability/anger correlated with a more chronic and severe long-term course of illness, with increased depressive severity, longer duration of the index MDE, and poorer impulse control. In addition, overt irritability/anger correlated with higher rates of lifetime comorbid substance abuse and anxiety disorder, more antisocial personality disorders, greater psychosocial impairment, reduced satisfaction with life, and an increased rate of bipolar II disorder among relatives. There was no correlation observed with suicide ideation or behavior. Comorbidity and other manic spectrum symptoms did not explain the results.

“This study extends results of cross-sectional investigations and indicates that irritability/anger during MDEs is a highly prevalent clinical marker of a more severe, chronic, and complex depressive illness,” the authors write. “Findings have important implications for assessment and treatment.”

Two authors disclosed financial ties to the pharmaceutical and biotechnology industries.

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