University Department of Psychiatry, Medical Psychology Unit for Suicide Research, University Hospital, De Pintelaan 185, B-9000 Gent, Belgium.
Psychiatry Res. 2010 Feb 28;181(2):141-4. doi: 10.1016/j.pscychresns.2009.07.011. Epub 2010 Jan 13.
This study aimed at determining the functional neuroanatomy of mental pain, a hitherto neglected symptom in the study of depression, which according to DSM-IV is stronglylinked with suicide. Mental pain (measured with the Orbach & Mikulincer Mental Pain Scale), suicidal ideation (measured using the Hamilton Rating Scale for Depression), hopelessness (measured using Beck's Hopelessness Scale), and regional cerebral blood flow as measured with single photon emission computed tomography were assessed in 39 depressed individuals. Levels of mental pain were significantly and positively associated with suicidal ideation and levels of hopelessness. When compared with patients with low levels of mental pain, those with high levels of mental pain showed relatively increased perfusion in the right dorsolateral prefrontal cortex, occipital cortex and inferior frontal gyrus and in the left inferior temporal gyrus, and relatively decreased perfusion at the medulla. The findings indicate that mental pain in depressed patients is associated with an increased risk of suicide and that high levels of mental pain are associated with changes in perfusion in brain areas that are involved in the regulation of emotions. Further study is warranted to understand whether this association reflects increased emotional processing or decreased cognitive control over mental pain in depressed individuals.
本研究旨在确定精神痛苦的功能神经解剖学，这是抑郁研究中一个迄今被忽视的症状，根据 DSM-IV 标准，它与自杀强烈相关。精神痛苦（用 Orbach 和 Mikulincer 精神痛苦量表测量）、自杀意念（用汉密尔顿抑郁评定量表测量）、绝望感（用贝克绝望量表测量）和用单光子发射计算机断层扫描测量的局部脑血流在 39 名抑郁患者中进行了评估。精神痛苦的程度与自杀意念和绝望感呈显著正相关。与精神痛苦程度低的患者相比，精神痛苦程度高的患者右侧背外侧前额叶皮层、枕叶皮层和下额回以及左侧下颞叶的灌注相对增加，而延髓的灌注相对减少。这些发现表明，抑郁患者的精神痛苦与自杀风险增加有关，而高水平的精神痛苦与参与情绪调节的脑区血流灌注变化有关。需要进一步研究以了解这种关联是否反映了抑郁个体中情绪处理的增加或对精神痛苦的认知控制的降低。
