Abstract: Objective To analyze the influencing factors of impulsive‐aggressive behavior in patients with bipolar affective disorder, and to provide reference for formulating effective intervention measures and reducing impulsive‐aggressive behavior in patients with bipolar affective disorder. Methods The patients diagnosed with bipolar affective disorder at a specialized hospital in Nanjing City from January 2021 to June 2022 were selected as the subjects, and the Modified Overt Aggression Scale （MOAS） was used to evaluate their impulsive‐aggressive behavior. The demographic data （gender, age, education level, and living pattern）, disease characteristics （onset form, disease classification, initial/recurrence, pre‐onset stress events, and insight）, and biological examination indicators [creatine kinase （CK）, creatine kinase isoenzyme （CK‐MB）, and brain electrical activity mapping] of patients were collected. Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors of impulsive‐aggressive behavior in patients with bipolar affective disorder. Results Among the 1 028 patients with bipolar affective disorder, 194 （18.87%） had impulsive‐aggressive behavior. Multivariate Logistic regression analysis showed that disease classification （OR=0.163）, initial/recurrence （OR=1.972）, pre‐onset stress events （OR=2.115）, insight （OR=2.980）, CK （OR=1.355）, and brain electrical activity mapping （OR=2.395） were influencing factors of impulsive‐aggressive behavior in patients with bipolar affective disorder. Conclusions Patients with bipolar affective disorder have a high risk of impulsive‐aggressive behavior. Bipolar disorder type I, recurrence, pre‐onset stress events, insight impairment, CK > upper limit, and abnormal brain electrical activity mapping will increase the impulsive‐aggressive behavior of patients with bipolar affective disorder. Effective intervention measures can be taken in advance to reduce impulsive‐aggressive behavior according to the individual situation of patients with bipolar affective disorder.

Key words: Bipolar affective disorder, Impulsive‐aggressive behavior, Modified Overt Aggression Scale, Influencing factor