Affective temperaments show potential for aggressive behavior (AB) preventive strategies
in bipolar disorder (BD). We aim to define intra-diagnostic subgroups of patients
with BD based on homogeneous behaviors related to AB. Subsequently, to assess whether
affective temperament dimensions may contribute to the presence and severity of AB.Patients
with BD were recruited. AB was evaluated through the modified overt aggression scale
(MOAS); affective temperaments were assessed with the TEMPS-A. A cluster analysis
was conducted based on TEMPS-A and MOAS scores. Stepwise backward logistic regression
models were used to identify the predictive factors of cluster membership.799 patients
with BD were enrolled. Three clusters were determined: non-aggressive (55.5 %), self-aggressive
(18 %), and hetero-aggressive (26.5 %). Depressive, irritable, and anxious temperament
scores significantly increased from the non-aggressive (lower) to the self-aggressive
(intermediate) and the hetero-aggressive group (highest). A positive history of a
suicide attempt (B = 5.131; OR = 169.2, 95 % CI 75.9; 377) and rapid cycling (B =
-0.97; OR = 0.40, 95 % CI 0.17; 0.95) predicted self-aggressive cluster membership.
Atypical antipsychotics (B = 1.19; OR = 3.28, 95 % CI 2.13; 5.06) or SNRI treatment
(B = 1.09; OR = 3, 95 % CI 1.57; 5.71), psychotic symptoms (B = 0.73; OR = 2.09, 95
% CI 1.34; 3.26), and history of a suicide attempt (B = -1.56; OR = 0.20, 95 % CI
0.11; 0.38) predicted hetero-aggressive cluster membership.Recall bias might have
affected the recollection of AB.Clinical factors orientate the prevention of different
ABs in BD. Affective temperaments might play a role in preventing AB since patients
with more pronounced affective temperaments might have an increased risk of showing
AB, in particular hetero-AB.
