Raju Msvk, Garg M K, Rajguru B, Srivastava K
Senior Advisor (Psychiatry), Base Hospital, Delhi Cantt 110 010.
Classified Specialist (Medicine and Endocrinology), Command Hospital (Central Command), Lucknow 226 002.
Med J Armed Forces India. 2002 Apr;58(2):114-9. doi: 10.1016/S0377-1237(02)80041-7. Epub 2011 Jul 21.
The biological underpinnings of suicidal behaviour and possible rational pharmacotherapy of persons exhibiting such behaviour is the focus of this study. The study was conducted on 25 male Armed Forces personnel who attempted suicide and 25 matched healthy controls. Hypothermic and Growth Hormone response to Buspirone challenge was measured serially. 11 cases of attempted suicide had subsensitive postsynaptic 5 HT-1A receptors as indicated by blunted Growth Hormone response, while in other suicidal soldiers hypothermic response was markedly blunted indicating subsensitive presynaptic 5HT-IA receptors in the latter. Personality factor assessment carried out by 16 personality factor test, indicated overt extraversion marks for subsensitive postsynaptic 5 HT-IA receptors, while overt intraversion marks for subsensitive presynaptic 5 HT-IA receptors, in suicidal soldiers. In the light of the above, therapeutic options of Serotonin reuptake inhibition, agonist load at presynaptic 5 HT-IA and reciprocal stimulation of postsynatpic 5 HT-IA receptors for prevention of future attempts and completed suicides is discussed.
本研究的重点是自杀行为的生物学基础以及对有此类行为者可能的合理药物治疗。该研究对25名企图自杀的男性武装部队人员和25名匹配的健康对照者进行。连续测量了对丁螺环酮激发试验的体温过低和生长激素反应。11例企图自杀者的生长激素反应迟钝,表明其突触后5-HT-1A受体不敏感,而其他自杀士兵的体温过低反应明显迟钝,表明后者的突触前5HT-IA受体不敏感。通过16种人格因素测试进行的人格因素评估表明,有突触后5-HT-IA受体不敏感者有明显的外向性特征,而有突触前5-HT-IA受体不敏感的自杀士兵有明显的内向性特征。鉴于上述情况,讨论了5-羟色胺再摄取抑制、突触前5-HT-IA激动剂负荷以及突触后5-HT-IA受体的反向刺激等治疗方案,以预防未来的自杀企图和自杀成功。