title: Anger attacks in depression--evidence for a male depressive syndrome.
abstract: BACKGROUND
  It has been proposed that aggression and especially anger attacks play an important role in the symptomatology of depression. Furthermore, it has been hypothesized that these symptoms are more prevalent in males than in females.
  
  
  METHODS
  We conducted a study in 217 depressed patients (104 females, 113 males) without psychiatric comorbidity using questionnaires. Study subjects had previously been treated as inpatients and were contacted after discharge from hospital by mail or phone. Overall response rate was 69.6%. Patients were asked to retrospectively rate their state during their last depression.
  
  
  RESULTS
  Males obtained higher scores on irritability (p = 0.010) and showed a tendency to overreact (p = 0.018) during their last depressive episode. They had suffered significantly more often from anger attacks than female patients (4.3 +/- 7.52 versus 1.2 +/- 2.97 anger attacks per month; p = 0.001). Further multivariate analyses displayed that men had significantly lower impulse control and more frequently showed symptomatic substance intake and hyperactive behavior during their depression, whereas women suffered more often from hypersomnia and heaviness in limbs (p < 0.0001).
  
  
  CONCLUSIONS
  Our findings are indicative of gender differences in symptoms related to lowered impulse control in depressed patients. Further study is required to replicate and extend our results and to assess the significance of aggression as a gender-specific diagnostic criterion for depression.
authors.affiliation: Department of General Psychiatry, Medical University of Vienna, Vienna, Austria. dietmar.winkler@meduniwien.ac.at
authors.forename: Dietmar
authors.initials: D
authors.lastname: Winkler
authors.forename: Edda
authors.initials: E
authors.lastname: Pjrek
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
mesh_terms: D000374:Aggression / Q000523:psychology; D000786:Anger; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D007508:Irritable Mood; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires