title: [The link between aggressive behavior and depression in adolescence. A cross-sectional study conducted in the psychiatric emergency unit at the Sainte-Anne hospital].
abstract: BACKGROUND
  The link between depression and aggressive behavior in adults has been found in many studies. In adolescents, this relationship is still controversial. Several studies point out that irritability is a key symptom in adolescent depressed. Few studies have analyzed precisely the kind of aggressive behavior. This study sets out to assess the relationship between aggressive behavior and depressive affects in adolescents. We also pay attention in this population to hopelessness feelings, anxiety, global functioning and the type of aggressive behavior.
  
  
  METHODS
  This is a descriptive and observational cross-sectional study. Data was collected from 49 successive adolescents admitted for a 24-hour evaluation in the emergency department of the Sainte-Anne psychiatric hospital. The inclusion period was from February to April 2012, with age limits between 15 and 18. For each patient, the clinician completed with the parents or other caregivers the Modified Overt Aggressive Scale (MOAS) searching for existence of aggressive behavior in the week prior to the consultation. The population was divided into two groups: P- group when the MOAS score was < 3 and the P+ group when the MOAS score was ≥ 3. The Global Assessment of Functioning Scale and Adolescent Depression Rating Scale for clinicians (ADRSc) were also completed. Each patient completed the self-report Buss-Perry Aggression Questionnaire (QA), the Beck Hopelessness scale and the Adolescent Depression Rating Scale for patients (ADRSp).
  
  
  RESULTS
  Forty-nine adolescents with a median age of 16 years and 4 months participated. The first reason for consultation was depressive symptoms, followed by disruptive behavior. The analysis was conducted on 39 questionnaires. The demographic profile of the two groups was similar. We did not find any significant difference between the groups P+ and P- on ADRSc scores and secondary criteria. However, we found higher scores in the QA in the more depressed patient, especially a higher hostility score in this sample. In the subgroup analysis: as expected self-aggressive behavior was associated with a higher depression score, more hospitalization and a poor global functioning score. Surprisingly, the patients who showed physical aggression against others had a better prognosis and lower depression scores.
  
  
  CONCLUSIONS
  The study did not conclude on the link between aggressive behavior and depression in this population. The adolescent hostility appears more characteristic of depression compared to other dimensions of aggressivity (anger, verbal aggression, physical aggression) in adolescents. Physical aggression against others appeared not only less typical in depression but was also associated with a better global functioning. Clinicians should pay particular attention to the kind of aggressive behavior in clinical evaluations of adolescents in an emergency context.
authors.affiliation: Centre psychiatrique d'orientation et d'accueil, hôpital Sainte-Anne, Assistance publique-Hôpitaux de Paris, 1, rue Cabanis, 75014 Paris, France; Service de psychiatrie de l'enfant et de l'adolescent, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: xavierbenarous@gmail.com.
authors.forename: X
authors.initials: X
authors.lastname: Benarous
authors.affiliation: Centre psychiatrique d'orientation et d'accueil, hôpital Sainte-Anne, Assistance publique-Hôpitaux de Paris, 1, rue Cabanis, 75014 Paris, France.
authors.forename: M J
authors.initials: MJ
authors.lastname: Guedj
authors.affiliation: Centre psychiatrique d'orientation et d'accueil, hôpital Sainte-Anne, Assistance publique-Hôpitaux de Paris, 1, rue Cabanis, 75014 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Braitman
authors.affiliation: Centre psychiatrique d'orientation et d'accueil, hôpital Sainte-Anne, Assistance publique-Hôpitaux de Paris, 1, rue Cabanis, 75014 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Gallois
authors.affiliation: Centre psychiatrique d'orientation et d'accueil, hôpital Sainte-Anne, Assistance publique-Hôpitaux de Paris, 1, rue Cabanis, 75014 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Lana
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000523:psychology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D004637:Emergency Services, Psychiatric; D005260:Female; D005602:France; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D010343:Patient Admission; D010552:Personality Assessment; D011379:Prognosis
keywords: Adolescent; Adolescents; Aggression; Agression; Crise; Crisis; Depressive disorder; Dépression; Psychiatric emergency; Urgences psychiatriques