DST and Suicide Prediction

简介(申请人提供)：自杀是一个主要的公共卫生问题 在美国。到目前为止，在多个临床病例中确定的主要危险因素 样本包括男性性行为、独居和自杀意念。最新数据 提示地塞米松对皮质醇无抑制作用 抑制试验(DST)可能是一种比其他方法更可靠的临床预测指标 变量。尸检数据进一步支持了这一点 HPA轴的激活，如肾上腺重量增加和POMC增加 基因在垂体前叶中的表达。此外，强有力的证据支持 皮质醇在调节大脑5-羟色胺系统中的作用。这个项目取决于 在存在诊断为重大疾病的大型主题数据库时 1978年至1987年间接受DST的抑郁症患者。所有科目也 在评估期间接受SADS访谈和每周HAM-D评级 后续行动。在确定索引病例后，我们将检查死亡率 特别是DST阳性和阴性受试者的自杀以及检查 其他一些潜在的自杀危险因素之间的关系 并彻底自杀。

DESCRIPTION (provided by applicant): Suicide is a major public health problem in the US. To date, the main risk factors identified in multiple clinical samples include male sex, living alone and suicidal ideation. Recent data suggest that demonstrating non-suppression to cortisol on the dexamethasone suppression test (DST) may be a more robust clinical predictor than these other variables. This is further supported by post-mortem data indicating chronic activation of the HPA axis such as increased adrenal weight and increased POMC mRNA in the anterior pituitary. Furthermore, strong evidence supports the effects of cortisol in modulating brain serotonin systems. This project depends upon the existence of a large database of subjects with the diagnosis of major depression who received the DST between 1978 and 1987. All subjects also received SADS interviews and weekly Ham-D ratings during assessment and follow-up. After identifying index cases, we will examine mortality rates particularly suicide in DST positive and negative subjects as well as examining the relationship between a number of other potential risk factors for suicide and completed suicide.