Direct and indirect hostility and self-destructive behavior by hospitalized depressives.

Suicidal and other self-destructive behavior was correlated with self-report (Buss-Durkee) and observer rated (Lion Scale) measures of hostility and violence in 45 male inpatients with major depressive episodes by DSM III criteria (296.2, 296.3, 296.5). Self-destructive acts were significantly correlated with a Buss-Durkee Indirect Hostility factor. Measures of directly expressed hostility and violence correlated with seclusion and restraint for self-protection. None of the Lion or Buss-Durkee measures correlated with depression measures, nor did self-destructive acts correlate with degree of depression in these severe patients. Thus our data indicate that, in patients with moderate to severe depression, self-destructive acts in hospital may be better correlated with feelings of anger and hostility than with depression itself.