White matter hyperintensities and their association with suicidality in depressed young adults
White matter hyperintensities and their association with suicidality in depressed young adults
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DOI：
10.1016/j.jad.2005.01.007
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发表时间：
2005-06-01
影响因子：
6.6
通讯作者：
Renshaw, PF
中科院分区：
文献类型：
--
作者：
Ehrlich, S;Breeze, JL;Renshaw, PF
研究人员和临床医生越来越认识到，生物标记物可能有助于识别有自杀风险的患者。本回顾性横断面研究的目的是比较的患病率和位置的白色物质高信号（WMH）在年轻的住院患者与抑郁症（MDD）的自杀attempts.Methods的历史：T2加权磁共振成像（MRI）的102名年轻的精神科住院患者与MDD的WMH的存在进行了评级。对病历进行审查，以确定自杀企图史、人口统计学和临床变量。Fisher精确检验和Logistic回归模型被用来测试WMH和suicidality.Results之间的关联：双变量分析表明，室周WMH的患病率显着较高的受试者与过去的自杀企图（Fisher精确检验，p = 0.02）。Logistic回归分析控制年龄，性别和几个临床危险因素支持这一发现（比值比= 5.7，95%置信区间：1.6，21.2）。局限性：由于我们的研究的回顾性，横断面设计，我们无法确定是否WMH之前或之后过去的自杀企图。我们的研究结果的普遍性是有限的，因为这组住院患者比一般精神病患者的病情更严重。与没有自杀史的类似抑郁症患者相比，患有MDD和有自杀企图史的年轻人脑室周围WMH的患病率增加，这与我们在儿童和青年中的发现一致，这表明除了社会心理因素外，自杀可能还有神经生物学因素。(c)2005 Elsevier B.V.保留所有权利。
Introduction: Researchers and clinicians have increasingly recognized that biological markers may help identify patients who are at risk for suicide. The objective of this retrospective, cross-sectional study was to compare the prevalence and location of white matter hyperintensities (WMH) in young inpatients with major depressive disorder (MDD) with and without histories of suicide attempts.Methods: T2-weighted magnetic resonance images (MRI) of 102 young psychiatric inpatients with MDD were rated for the presence of WMH. Medical charts were reviewed to ascertain history of suicide attempt, demographic and clinical variables. Fisher's Exact Tests and logistic regression modeling were used to test the association between WMH and suicidality.Results: Bivariate analysis showed that the prevalence of periventricular WMH was significantly higher in subjects with past suicide attempts (Fisher's Exact Test, p = 0.02). Logistic regression analyses controlling for age, sex, and several clinical risk factors supported this finding (odds ratio = 5.7; 95% confidence interval: 1.6, 21.2).Limitations: Due to the retrospective, cross-sectional design of our study, we are unable to determine if the WMH preceded or followed past suicide attempts. The generalizability of our findings is limited since this group of inpatients is more severely ill than the general psychiatric population.Conclusions: The increased prevalence of periventricular WMH in young adults with MDD and a history of suicide attempt, compared to similarly depressed adults without such a history, is consistent with our findings in children and youth, and suggests there might be neurobiological in addition to psychosocial risk factors for suicide. (c) 2005 Elsevier B.V. All rights reserved.