Aggression; Depression; Impulsivity; Schizophrenia; Suicide
Background: Aggressive behavior and impulsivity have been proposed as predictors for suicide suicidal behavior. Around 90% of individuals who complete suicide have a psychiatric disorder at the time of the death and people with such conditions have a 10-20 times higher risks for suicide. Major depression and schizophrenia play an important role among psychiatric diagnoses associated with suicidal behaviors, both diagnoses with high prevalence of suicide attempt when compared to general population. Suicidal behavior is a phenomenon related to several risk factors including: demographic features, clinical characteristics of the mental disorder, and genetic predisposition. Due to its heterogeneity and hereditary complexity, there is a need to study proposed intermediate phenotypes, like impulsivity and aggressive behavior in people with mental disorders. Impulsivity is conceived as a predisposition toward rapid, unplanned reactions to internal or external stimuli regardless of the negative consequences of these reactions to themselves or others. It has an important role as a risk factor for suicide behavior. Aggression instead, is a reaction precipitated by stimuli that generate rage, or a behavior aimed to cause physical damage to persons or properties. Suicidal patients with impulsive personality features display aggressive behaviors more frequently. The link between aggression and impulsivity is still ambiguous as their association has not been replicated in all the scientific studies performed. Objectives: To compare aggression and impulsivity in patients with depression and schizophrenia with a history of suicide attempts; to determine the association between impulsivity and aggression in both groups. Method: One-hundred Mexican outpatients were included in this study if they were over 18 years of age, met SCID-DSM-IV criteria for schizophrenia (n=50) or unipolar depression diagnosis (n=50) and had a history of suicide attempts. Patients were excluded if they had any concomitant medical or neurological illness, current substance abuse or dependence, with the exception of nicotine, if they were agitated. All patients were assessed with the Overt-Aggression-Scale and the Plutchik's-Impulsivity-Scale. Demographic data, clinical features, and characteristics of suicide attempts were collect