White matter hyperintensities and their associations with suicidality in patients with major affective disorders
White matter hyperintensities and their associations with suicidality in patients with major affective disorders
复制标题
DOI：
10.1007/s00406-007-0755-x
复制
发表时间：
2007-12-01
影响因子：
4.7
通讯作者：
Girardi, Paolo
中科院分区：
文献类型：
--
作者：
Pompili, Maurizio;Ehrlich, Stefan;Girardi, Paolo
大量的证据表明，自杀倾向，一个重要的公共卫生问题，是介导的神经生物学因素在一定程度上。这项横断面研究的目的是比较有和没有自杀企图史的严重情感障碍患者中白色高信号（WMH）的患病率。方法对65例精神科住院的抑郁症或双相情感障碍患者进行T2加权磁共振成像（MRI）检查，评估WMH的存在。诊断，存在或不存在自杀风险和药物滥用是由迷你国际神经精神访谈（MINI）。病历进行了审查，以确定历史的自杀企图和基本的临床变量。Fisher精确检验和逻辑回归模型用于检验WMH和自杀倾向之间的关联。自杀患者和对照组在人口统计学变量和暴露于某些危险因素方面不匹配。结果双变量分析显示，有自杀企图史（Fisher精确检验，p = 0.01）和其他自杀风险升高的临床指标的受试者中，WMH的患病率显著较高。控制年龄、性别和几个临床危险因素的Logistic回归分析支持这一发现（比值比= 4.7; 95%置信区间：1.4，16.1）。结论：与无自杀未遂史的类似患者相比，患有严重情感性精神障碍和自杀未遂史的成年人中WMH的患病率增加，这与先前在抑郁儿童，青年和年轻人中的研究结果一致。然而，WMH和自杀倾向之间的关联对抑郁症和双相情感障碍患者都适用。我们的研究结果表明，WMH在重大情感障碍患者可能是有用的生物学标记的自杀倾向。
Introduction A large body of evidence suggests that predisposition to suicide, an important public health problem, is mediated to a certain extent by neurobiological factors. The objective of this cross-sectional study was to compare the prevalence of white matter hyperintensities (WMH) in patients with major affective disorders with and without histories of suicide attempts. Methods T2-weighted magnetic resonance images (MRI) of 65 psychiatric inpatients with major depressive disorder or bipolar disorder were rated for the presence of WMH. Diagnoses, presence or absence of suicide risk and substance abuse were determined by the Mini International Neuropsychiatric Interview (MINI). Medical charts were reviewed to ascertain history of suicide attempt and basic clinical variables. Fisher's Exact Tests and logistic regression modeling were used to test the association between WMH and suicidality. Suicidal patients and controls were not matched for demographic variables and exposure to some risk factors. Results Bivariate analysis showed that the prevalence of WMH was significantly higher in subjects with past suicide attempts (Fisher's Exact Test, p = 0.01) and other clinical indicators of elevated suicide risk. Logistic regression analyses controlling for age, sex, and several clinical risk factors supported this finding (odds ratio = 4.7; 95% confidence interval: 1.4, 16.1). Conclusions The increased prevalence of WMH in adults with major affective disorders and a history of suicide attempt, compared to similar patients without such a history, is consistent with previous findings in depressed children, youth and young adults. However, the association between WMH and suicidality holds true for both, depressed and bipolar patients. Our results suggest that WMH in patients with major affective disorders might be useful biological markers of suicidality.