Pharm Sci. 2020;26(4): 386-392.
doi: 10.34172/PS.2020.22
  Abstract View: 198
  PDF Download: 90

Research Article

Psychophysiological Characteristics of Aggression Associated with Depression before and after Successful Treatment with Sertraline: A Clinical Trial Study

Alireza Farnam 1 ORCID logo, Arezoo Mehrara 1, Saeideh Aghayari Sheikh Neshin 2, Masumeh Zamanlu 1, Mohammad Ali Nazari 3, Mohammadbagher Hassanzadeh 1, Hossein Dadashzadeh 1, Masoud Nouri-Vaskeh 4,5* ORCID logo

1 Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Neuroscience Research Center, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
3 Cognitive Neuroscience Laboratory, Department of Psychology, University of Tabriz, Tabriz, Iran.
4 Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
5 Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.


Background: Depression associated with aggression can lead to violent behaviors. The present study was aimed to determine how sertraline, a standard medication for depression treatment, can efficiently decrease aggression and affect psychophysiological parameters in patients with depression.
Methods: Patients with depression and aggression were included in a six-week trial with sertraline (50 100 mg/day). Depression diagnosis was confirmed by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Text Revision (DSM-IV-TR). Depression severity before and after treatment was assessed using Beck Depression Inventory (BDI).
Aggression was evaluated by Spielberger’s State-Trait Anger Expression Inventory-2 (STAXIII). The BDI and STAXI-II were finally applied to evaluate the effectiveness of treatment. For each patient, peripheral and central psychophysiological parameters were recorded using peripheral biofeedback apparatus and electroencephalogram in the initial and final stages of treatment. These recordings were attempted to assess variations of the autonomic nervous system and electrocortical activity in response to treatment.
Results: Depressive and aggressive symptoms decreased significantly over the six-week treatment period, as measured by BDI and STAXI-II. Significant changes in some of the peripheral and central psychophysiological variables were observed. Sensorimotor rhythm (SMR)/theta ratio (p=0.01) have decreased during a task, delta (p=0.02) and theta (p=0.008) wave activity and theta/alpha ratio (p=0.01) have increased during task, and theta/beta ratio has increased during both rest and task (p=0.02 for both). Among peripheral psychophysiological variables, skin conductance during task decreased significantly (p=0.03).
Conclusion: Several numbers of psychophysiological parameters were influenced significantly after successful pharmacotherapy of aggressiveness in patients with depression.
Keywords: Aggression, Depression, Biofeedback, Neurofeedback, Sertraline
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Submitted: 12 Sep 2019
Revision: 10 Dec 2019
Accepted: 09 Jan 2020
ePublished: 25 Dec 2020
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