Irritability in Major Depressive Episode Associated with More Severe Illness


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JAMA Psychiatry Study Highlights


Irritability in Major Depressive Episode Associated with More Severe Illness


Irritability and anger during a major depressive episode (MDE) were associated with increased depressive severity, longer durations of the index episode, poorer impulse control and a more chronic and severe long-term course of the illness, according to a study by Lewis L. Judd, M.D., of the University of California, San Diego, and colleagues.


Researchers sought to determine the prevalence of overtly expressed irritability/anger in MDE and its association with illness presentation and long-term course among 536 patients followed for up to 31 years. Patients entered the National Institute of Mental Health Collaborative Depression Study during an MDE in 1978, 1979, 1980 or 1981. Overt irritability/anger was present in 292 of 536 patients (54.5 percent) at intake.


“It was associated with significantly increased depressive severity, longer duration of the index MDE, poorer impulse control, a more chronic and severe long-term course of illness, higher rates of lifetime comorbid substance abuse and anxiety disorder, more antisocial personality disorders, greater psychosocial impairment before intake and during follow-up, reduced life satisfaction, and a higher rate of bipolar II disorder in relatives,” the authors conclude.

(JAMA Psychiatry. Published online September 11, 2013. doi:10.1001/jamapsychiatry.2013.1957. Available pre-embargo to the media at


Editor’s Note: Authors made conflict of interest disclosures. The initial funding source for the database used in this study was the NIMH. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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