Q. I am studying psychology in Belgium and I am doing research on bipolar disorders for school, especially on the hostility bipolar patients display against themselves (suicide, automutilation) and against others (verbal and physical). I wanted to ask your help to find some information (websites, book references, testimonies, articles...) about my research. I am have some trouble finding information concerning the hostility bipolar patients dispaly against the others. Can you offer any help?

A. This is an important topic, since some studies show that the rate of suicide in bipolar disorder is as high as 19% (Goodwin & Jamison, Manic-Depressive Illness, 1990--the classic text on the topic). Anger, hostility, and aggression are also commonly seen in bipolar disorder, usually in so-called mixed episodes (also called dysphoric mania).

Posternak & Zimmerman (J Clin Psychiatry 2002 Aug;63(8):665-72) found that major depressive disorder, bipolar I disorder, intermittent explosive disorder, and cluster B personality disorders independently contributed to the presence of both anger and aggression. Sato et al (Am J Psychiatry 2002 Jun;159(6):968-74) describe several subtypes of mania, including an aggressive subtype.

Anger may also be seen as a psychological reaction in bipolar patients, as they confront the stresses of their disorder and its
impact on job, family, etc. A good general reference on Bipolar Disorder is the volume edited by JF Goldberg and M. Harrow (Bipolar Disorders: Clinical Course and Outcome, 1999).

You can also locate online information at http://www.ndmda.org, the site of the Naional Depressive and Manic Depressive Association.

Other Resources:

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September 2003

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