title: Major depressive disorder with anger attacks and subcortical MRI white matter hyperintensities.
abstract: Previous reports of increased rates of cardiovascular risk factors in major depressive disorder (MDD) with anger attacks led the authors to hypothesize that MDD with anger attacks may be associated with brain vascular changes (magnetic resonance imaging white matter hyperintensities [WMHs]). Sixty-five subjects meeting DSM-III-R criteria for major depressive disorder were administered brain magnetic resonance imaging scans at 1.5T to detect T2 WMH. The severity of brain WMH was classified with the Fazekas scale. We used standardized scales to assess melancholic MDD, atypical MDD, and MDD with anger attacks. In logistic regression analyses, MDD with anger attacks was associated with higher severity of subcortical WMH and of total WMH, but not with periventricular WMH. Atypical and melancholic MDD subtypes were not significantly associated with brain WMH. In conclusion, subcortical brain vascular lesions may be more prevalent or severe in MDD with anger attacks.
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Dan V
authors.initials: DV
authors.lastname: Iosifescu
authors.forename: Perry F
authors.initials: PF
authors.lastname: Renshaw
authors.forename: Darin D
authors.initials: DD
authors.lastname: Dougherty
authors.forename: In Kyoon
authors.initials: IK
authors.lastname: Lyoo
authors.forename: Ho Kyu
authors.initials: HK
authors.lastname: Lee
authors.forename: Renerio
authors.initials: R
authors.lastname: Fraguas
authors.forename: Paolo
authors.initials: P
authors.lastname: Cassano
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Nierenberg
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
mesh_terms: D000328:Adult; D000786:Anger / Q000502:physiology*; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D002552:Cerebral Ventricles / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D012720:Severity of Illness Index