Major depressive disorder with anger attacks and subcortical MRI white matter hyperintensities

Dan V. Iosifescu, Perry F. Renshaw, Darin D. Dougherty, In Kyoon Lyoo, Ho Kyu Lee, Renerio Fraguas, Paolo Cassano, Andrew A. Nierenberg, Maurizio Fava

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Previous reports of increased rates of cardiovascular risk factors in major depressive disorder (MDD) with anger attacks led the authors to hypothesize that MDD with anger attacks may be associated with brain vascular changes (magnetic resonance imaging white matter hyperintensities [WMHs]). Sixty-five subjects meeting DSM-III-R criteria for major depressive disorder were administered brain magnetic resonance imaging scans at 1.5T to detect T2 WMH. The severity of brain WMH was classified with the Fazekas scale. We used standardized scales to assess melancholic MDD, atypical MDD, and MDD with anger attacks. In logistic regression analyses, MDD with anger attacks was associated with higher severity of subcortical WMH and of total WMH, but not with periventricular WMH. Atypical and melancholic MDD subtypes were not significantly associated with brain WMH. In conclusion, subcortical brain vascular lesions may be more prevalent or severe in MDD with anger attacks.

Original languageEnglish
Pages (from-to)175-178
Number of pages4
JournalJournal of Nervous and Mental Disease
Issue number2
StatePublished - Feb 2007


  • Anger attacks
  • Major depressive disorder
  • White matter lesions


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