The Aggressive Behavior And Brain Imaging Changes In Patients With Major Depression Disorder And The Relationship With Childhood Abuse

Objective：To investigate the characteristics of aggressive behavior inpatients with major depression disorder (MDD), and its relationship withchild abuse, in order to provide evidence for the prevention andintervention of aggressive behavior in depression disorder patients.Methods: Eighty depression disorder patients came from theoutpatient and inpatient department of Mental Health Center consecutivelywere included. MDD was diagnosed according to Structured ClinicalInterview for DSM-IV-TR Axis I Disorders-Patient Edition (SCID-I/P), andassessed by17-item Hamilton Depression Rating Scale (HAMD). HAMDscores were requested≥17. Eighty healthy controls were concluded too,who the scores of BDI must≤5. The Childhood Trauma Questionnaire(CTQ), Modified Overt Aggression Scale (MOAS), AggressionQuestionnaire was simultaneously used to evaluate patients with MDD andhealth controls. Spearman correlation analysis was applied to test therelationship between aggression behavior and childhood abuse.Results:1. The incidence of childhood abuse and total scores ofphysical abuse, emotional abuse, sexual abuse, emotional neglect andphysical neglect were all higher than that in normal controls (P<0.05).2. The total score of MOAS and the scores of verbal aggression, propertyaggression, self-aggression, physical aggression, anger, hostility werehigher than that in normal control group (P<0.05).3. Correlation analysisdisplayed that the total score of MOAS, the score of verbal aggression,anger, hostility was positively correlated with the total score of CTQ,physical abuse, emotional abuse, sexual abuse, emotional neglect andphysical neglect respectively (r=0.24～0.52, P<0.05). Property aggressionwas positively correlated with the total score of CTQ, physical abuse,emotional abuse, emotional neglect and physical neglect (r=0.28～0.406,P<0.01). Self-aggression was positively correlated with the total score ofCTQ, physical abuse, emotional abuse, sexual abuse, physical neglect(r=0.23～0.327, P<0.05). Physical aggression was positively correlatedwith the total score of CTQ and emotional abuse (r=0.206～0.214,P<0.05).Conclusion: Depression patients have aggressive behaviors bothpoint to the outside and inside and have the higher incidence of childhoodabuse also. The seriousness of aggressive behavior is correlated with theseriousness of child abuse. So clinicians should pay more attention to theaggressive behavior of depression patients who having experience ofchildhood abuse, in order to prevent the occurrence of crisis events. Objective：To explore the brain structural change associated withdepression and aggressive behavior, and its relationship with childhoodabuse in patients with MDD.Methods: Thirty patients with MDD and thirty health controlsmatched with gender, age and educational from the eighty patients andeighty controls before, were undergo3.0-Tesla magnetic resonance imagingordering to VBM.Results:1. The gray matter volume about right superior, middle andinferior frontal gyrus, inferior parietal lobule, and left precental gyrus,supramarginal had decreased in MDD patients than that in health controls;and the gray matter volume about right superior and middle temporal gyrus,parahippocampal gyrus, left superior temporal gyrus, fusiform gyrus hadincreased in MDD patients than that in health controls. The white mattervolume of right inferior frontal gyrus, medial frontal gyrus and inferiorparietal gyrus had decreased in patients with MDD than that in healthcontrols.2. The gray matter volume of right inferior frontal gyrus,precental gyrus, postcentral gyrus, inferior parietal lobule and left angulargyri, supramarginal, anterior cingulate cortex were negatively correlatedwith verbal aggression.3. In MDD patients the gray matter of leftsupramarginal gyrus, precental gyrus which difference with controlsnegatively correlated with emotional neglect at the same time(r valueswere-0.45and-0.33respectively；P<0.05); and the right middle frontalgyrus was negatively correlated with physical neglect at the same time (rvalues was-0.33；P<0.05). And the left supramarginal gyrus whichnegatively correlated with verbal aggression, at the same time negativelycorrelated with emotional neglect too (r values was-0.31；P<0.05); and right postcentral gyrus which negatively correlated with verbal aggression,at the same time negatively correlated with physical neglect too (r valueswas-0.62；P<0.05).Conclusion: The occurrence of depression and its aggressivebehaviors may be related to the childhood abuse experience and thespecific brain regions damage of the patients.