Anger and Aggression in Psychiatric Outpatients
J Clin Psychiatry 2002;63:665-672
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: This study sought to
evaluate the degree of anger and aggression
experienced by psychiatric outpatients and to
determine whether anger is as prominent an emotional
state in these patients as are depression and
anxiety. We also sought to determine which Axis I
and Axis II disorders were associated with
increased rates of subjective anger and aggressive behavior.
Method: 1300 individuals presenting to a
psychiatric outpatient practice underwent
semistructured interviews to evaluate current DSM-IV
Axis I (N=1300) and Axis II disorders (N=687). Levels of subjective anger and aggression
during the preceding week were assessed in each
patient, and the odds ratios were calculated for each
disorder. A multiple regression analysis was
performed to determine which psychiatric disorders
independently contributed to the presence of
subjective anger and aggressive behavior.
Results: Approximately one half of
our sample reported currently experiencing
moderate-to-severe levels of subjective anger, and
about one quarter had demonstrated aggressive
behavior in the preceding week. This level of anger
was found to be comparable to the levels of
depressed mood and psychic anxiety reported by our sample. Major depressive disorder, bipolar I
disorder, intermittent explosive disorder, and
cluster B personality disorders independently
contributed to the presence of both anger and aggression.
Conclusion: Anger and aggression are
prominent in psychiatric outpatients to a degree
that may rival that of depression and anxiety; it
is therefore important that clinicians routinely screen for these symptoms.