Insight, psychosis and aggressive behaviour in mania

Background and Objectives: Aggressiveness is a common component of manic symptoms. The aim of this study was to determine the clinical characteristics associated with aggressive behaviour in bipolar patients with acute manic episodes. Methods: A study was carried out with 173 patients who met the DSM-IV criteria for manic or mixed bipolar disorder. Clinical and demographic variables were evaluated using the Positive and Negative Symptoms Scale (PANSS), the Young Mania Rating Scale (YMRS), the Brief Psychiatric Rating Scale (BPRS), and the Hamilton Depression Rating Scale (HDRS). Significance and independence of relevant variables were tested with regression models. Results: Forty percent of patients displayed aggressive behaviour. Involuntary nature of admission, positive psychotic symptoms and lack of insight were predictors of aggressive behaviour in manic patients. Conclusions: Aggressive behaviour during acute manic episodes appears to be related with the severity of the psychopathology, and particularly positive psychotic symptoms, involuntary admissions and lack of insight.