PSYCHOBIOLOGY OF SUICIDAL BEHAVIOR IN BPD

描述（改编自申请人摘要）：本提案是一项 竞争的第一个，多方面的临床研究， 患者自杀行为的心理社会和生物学危险因素 边缘型人格障碍（BPD），一种自杀性疾病 完成率为3 - 9%，与情感和精神分裂症相当 紊乱 反复自杀企图，自伤， 冲动性攻击是BPD患者特征， 与心理社会和生物因素有关，包括儿童史 滥用和中枢神经系统功能减退，通过CSF测量 单胺代谢物和神经内分泌反应芬氟拉明（FEN）。 在这项研究中，BPD患者与抑郁症患者进行了比较， 正常对照的措施，肾上腺素能功能和历史， 儿童期虐待，除了诊断和临床风险因素 之前定义的，并随访1年，以测试这些 变量作为自杀行为的风险因素。 在一个新的方向， 在FEN挑战期间引入PET-FDG神经成像，以测量 前额皮质对肾上腺素能激活的反应。 研究患者数 在最初的赠款期间，将每年遵循，以加强 先前定义的风险因素的预测分析，包括 共病抑郁症，物质使用障碍，高冲动和 攻击性，人际压力，低社会支持和缺乏 精神治疗

DESCRIPTION (adapted from applicant's abstract): This proposal is a competing continuation of a first, multidimensional study of the clinical, psychosocial and biological risk factors for suicidal behavior in patients with Borderline Personality Disorder (BPD), a disorder with a suicide completion rate of 3-9 percent, comparable to affective and schizophrenic disorders. Recurrent suicide attempts, self-injury, and impulsive-aggression are defining characteristics of patients with BPD, related to psychosocial and biologic factors, including childhood histories of abuse and diminished central serotonergic function, measured by CSF monoamine metabolites and the neuroendocrine response to Fenfluramine (FEN). In this study, patients with BPD are compared to depressed patients and normal controls on measures of serotonergic functioning and histories of childhood abuse, in addition to the diagnostic and clinical risk factors previously defined, and followed for 1 year to test the role of these variables as risk factors for suicidal behavior. In a new direction, PET-FDG neuroimaging is introduced during the FEN challenge to measure prefrontal cortical response to serotonergic activation. Patients studied in the original grant period will be followed annually to strengthen the predictor analyses of previously defined risk factors, which include co-morbid depression, substance use disorder, high impulsivity and aggressivity, interpersonal stressors, low social support and absence of psychiatric treatment.