The relationship between aggressiveness and suicidality in depression
A preliminary study

3rd Psychiatric Ward, Psychiatric Hospital of Thessaloniki

Aim: The aim of this study is to investigate the relationship between aggressiveness and suicide. Aggressive behavior is considered to be an important risk factor for suicidal behavior and suicide may even be the extreme expression of aggressiveness.

Material and Method: The relationship between aggressive behavior and suicide was investigated in twenty eight (28) depressed patients (13 males and 15 females, mean age 49,39±14,12 years) admitted in psychiatric department (C psychiatric ward, Psychiatric Hospital of Thessaloniki). All patients were in the acute phase of unipolar depression and were included in the study independently of the severity of the illness. The diagnosis of depression was assessed according to DSM-IV criteria. Severity of depression and suicidality were assessed by Hamilton scale10. aggressive behavior was assessed by means of special scales of MMPI for the investigation of hostility, violence impulsivity, inhibition of aggression and somatization. These scales were adjusted to the Greek population11. For the statistical analysis student t-test was used and Pearson correlation coefficient was assessed.

Results: There is a statistically significant negative correlation between the severity of depression and the inhibition of aggression (r=-0.382, p<0.05). Despite the increase in impulsivity and the reduction of hostility observed in correction with the severity of depression (according to Hamilton scale), when Pearson correlation coefficient was assessed, this correlation was not statistically important.

Statistically significant correlations were found among the parameters of aggression. Analytically, a negative correlation between the inhibition of aggression and violence (r=-0.431, p<0.05) and the inhibition of aggression and impulsivity (r=-0.391, p<0.05) were observed. Not suprisingly, there was also a positive correlation between violence and hostility (r=0.655, p<0.05) as well as between hostility and impulsivity (r=0.577, p<0.05).

The severity of depression is negatively correlated with the inhibition of aggression and somatization but not with impulsivity, hostility and aggression. Ádditionally, a statistically significant correlation between suicidal attempts and violence as well as between suicidal thoughts without attempts of suicide and inhibition of aggresion have been confirmed.

Conclusions: The results of this study indicate that the scores of the parameters of aggression measured in the patients were within the limits of general population.

Correlations such as a greater score of inhibition of aggression in patients with less severe depression and in patients with suicidal thoughts but not attempts were observed. It seems that suicidal thought is a symptom of depression, in which expressed emotion does not constitute the most important element. Suicidal thoughts emerge when the cognitive sphere is involved in depression. As far as suicidal attempts are concerned , violence and impulsivity are involved. These factors may annul the behavioral inhibition and psychomotor retardation typical of depression and lead to a suicidal attempt.

Key words: Depression, suicidality, aggressiveness.