Lee Yu Jin, Kim Soohyun, Gwak Ah Reum, Kim Seog Ju, Kang Seung-Gul, Na Kyoung-Sae, Son Young-Don, Park Juhyun
Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
Compr Psychiatry. 2016 May;67:59-65. doi: 10.1016/j.comppsych.2016.02.013. Epub 2016 Mar 2.
This study investigated regional gray matter (GM) volume differences between suicide attempters and suicide non-attempters with major depressive disorder (MDD) and their relationship with psychological risk factors for suicidality.
MDD patients with and without a suicide attempt history (n=19 in each group) participated. The Hamilton Depression Rating Scale, Clinical Global Impression (severity subscale), Scale for Suicide Ideation (SSI), Risk-Rescue Rating (RRR), Beck Hopelessness Scale (BHS), Barrett Impulsivity Scale, Eysenck Personality Questionnaire, and Ways of Coping Checklist (WCCL) were administered. T1-weighted structural magnetic resonance imaging scans were acquired to evaluate changes in GM volume. Voxel-based morphometry was performed using the SPM 8 software package. Two-sample t-tests were used during second-level group comparison analysis; partial correlation analysis controlling for gender and age identified associations between regional GM volume and psychological measures.
Suicide attempters exhibited significantly decreased GM volume in the left angular gyrus (p<0.001, uncorrected) and right cerebellum (p<0.001, uncorrected). GM volume in the left angular gyrus was inversely correlated with BHS scores (r=-0.55, p<0.01) and positively correlated with the Seeking Social Support subscale of the WCCL (r=0.43, p<0.01).
These findings provide evidence of a neural basis of suicidal behaviors in MDD. In particular, reduced GM volume in the left angular gyrus may be a neurobiological marker of suicidality in depressed patients.
本研究调查了伴有重性抑郁障碍（MDD）的自杀未遂者与未自杀者之间的区域灰质（GM）体积差异，以及它们与自杀相关心理危险因素的关系。
纳入有和无自杀未遂史的MDD患者（每组n = 19）。使用汉密尔顿抑郁量表、临床总体印象（严重程度分量表）、自杀意念量表（SSI）、风险 - 救援评定量表（RRR）、贝克绝望量表（BHS）、巴雷特冲动性量表、艾森克人格问卷和应对方式清单（WCCL）进行评估。采集T1加权结构磁共振成像扫描以评估GM体积变化。使用SPM 8软件包进行基于体素的形态学分析。在二级组比较分析中使用两样本t检验；控制性别和年龄的偏相关分析确定了区域GM体积与心理测量指标之间的关联。
自杀未遂者左侧角回的GM体积显著减小（p < 0.001，未校正），右侧小脑的GM体积也显著减小（p < 0.001，未校正）。左侧角回的GM体积与BHS评分呈负相关（r = -0.55，p < 0.01），与WCCL的寻求社会支持分量表呈正相关（r = 0.43，p < 0.01）。
这些发现为MDD患者自杀行为的神经基础提供了证据。特别是，左侧角回GM体积减小可能是抑郁症患者自杀倾向的神经生物学标志物。
