Ballard Elizabeth D, Ionescu Dawn F, Vande Voort Jennifer L, Slonena Elizabeth E, Franco-Chaves Jose A, Zarate Carlos A, Grillon Christian
Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
J Affect Disord. 2014 Jun;162:34-8. doi: 10.1016/j.jad.2014.03.027. Epub 2014 Mar 27.
Suicide is a common reason for psychiatric emergency and morbidity, with few effective treatments. Anxiety symptoms have emerged as potential modifiable risk factors in the time before a suicide attempt, but few studies have been conducted using laboratory measures of fear and anxiety. We operationally defined fear and anxiety as increased startle reactivity during anticipation of predictable (fear-potentiated startle) and unpredictable (anxiety-potentiated startle) shock. We hypothesized that a lifetime history of suicide attempt (as compared to history of no suicide attempt) would be associated with increased fear-potentiated startle.
A post-hoc analysis of fear- and anxiety-potentiated startle was conducted in 28 medication-free patients with Major Depressive Disorder (MDD) divided according to suicide attempt history.
The magnitude of fear-potentiated startle was increased in depressed patients with lifetime suicide attempts compared to those without a lifetime history of suicide attempt (F(1,26)=5.629, p=.025). There was no difference in anxiety-potentiated startle by suicide attempt history.
This is a post-hoc analysis of previously analyzed patient data from a study of depressed inpatients. Further replication of the finding with a larger patient sample is indicated.
Increased fear-potentiated startle in suicide attempters suggests the role of amygdala in depressed patients with a suicide attempt history. Findings highlight the importance of anxiety symptoms in the treatment of patients at increased suicide risk.
自杀是精神科急诊和发病的常见原因，有效治疗方法很少。焦虑症状已成为自杀企图前一段时间内潜在的可改变风险因素，但很少有研究使用恐惧和焦虑的实验室测量方法。我们将恐惧和焦虑操作性地定义为在预期可预测（恐惧增强惊吓）和不可预测（焦虑增强惊吓）电击时惊吓反应性增加。我们假设，有自杀企图史（与无自杀企图史相比）与恐惧增强惊吓增加有关。
对28名未服用药物的重度抑郁症（MDD）患者进行了恐惧和焦虑增强惊吓的事后分析，这些患者根据自杀企图史进行了分组。
与无自杀企图史的抑郁症患者相比，有自杀企图史的抑郁症患者恐惧增强惊吓的程度增加（F(1,26)=5.629，p=.025）。自杀企图史对焦虑增强惊吓没有差异。
这是对先前分析的住院抑郁症患者研究中的患者数据进行的事后分析。表明需要用更大的患者样本进一步重复这一发现。
自杀企图者恐惧增强惊吓增加表明杏仁核在有自杀企图史的抑郁症患者中起作用。研究结果突出了焦虑症状在治疗自杀风险增加患者中的重要性。
