Periventricular white matter hyperintensities as predictors of suicide attempts in bipolar disorders and unipolar depression.
The aim of this study was to evaluate whether deep white matter hyperintensities (DWMH) and periventricular white matter hyperintensities (PVH) are associated with suicidal behavior in patients with major affective disorders. Subjects were 99 consecutively admitted inpatients (42 men; 57 women; mean age: 46.5 years [SD=15.2; Min./Max.=19/79]) with a diagnosis of major affective disorder (bipolar disorder type I, bipolar disorder type-II and unipolar major depressive disorder). 44.4% of the participants had made at least one previous suicide attempt. T2-weighted brain magnetic resonance images were rated for the presence and extension of WMH using the modified Fazekas scale. Patients were interviewed for clinical data on average 5 days after admission. Bivariate analyses, corrected for multiple-testing, and logistic regression analysis were used to test the association between suicide attempts and clinical variables. Attempters and nonattempters differed only in the presence of PVH--the former were more likely to have PVH. The logistic regression indicated that the presence of PVH was robustly associated with suicidal behaviors after controlling for age (OR: 8.08). In conclusion, neuroimaging measures may be markers of risk for suicidal attempts in patients with major affective disorders.
Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Italy. maurizio.pompili@uniroma1.it
Maurizio
M
Pompili
Marco
M
Innamorati
J John
JJ
Mann
Maria A
MA
Oquendo
David
D
Lester
Antonio
A
Del Casale
Gianluca
G
Serafini
Silvia
S
Rigucci
Andrea
A
Romano
Antonino
A
Tamburello
Giovanni
G
Manfredi
Eleonora
E
De Pisa
Stefan
S
Ehrlich
Giancarlo
G
Giupponi
Mario
M
Amore
Roberto
R
Tatarelli
Paolo
P
Girardi
D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000473:pathology* / Q000523:psychology*; D002552:Cerebral Ventricles / Q000473:pathology*; D003866:Depressive Disorder / Q000473:pathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D013406:Suicide, Attempted / Q000523:psychology*