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首发非情感性精神病患者自杀行为的脑灰质异常:神经认知功能的作用。

Brain grey matter abnormalities in first episode non-affective psychosis patients with suicidal behaviours: The role of neurocognitive functioning.

机构信息

Department of Psychiatry, Hospital Germans Trias i Pujol, Barcelona, Spain.

Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2020 Aug 30;102:109948. doi: 10.1016/j.pnpbp.2020.109948. Epub 2020 Apr 17.

DOI:10.1016/j.pnpbp.2020.109948
PMID:32305356
Abstract

BACKGROUND

Suicide is one of the leading causes of premature death in first-episode psychosis (FEP) patients. The understanding of suicidal behaviour (SB) is limited, and new and integrative approaches focusing on the likely relationship of the biological and cognitive features of SB in the early phases of psychosis are warranted. We aimed to study the relationship of brain grey matter anomalies and cognitive functioning with SB or suicidal risk in a large sample of non-affective FEP patients.

METHODS

We used a voxel-based morphometry analysis in 145 FEP patients to investigate the pattern of structural brain abnormalities related to SB. In addition, bivariate and multivariate analyses were performed to explore the relationship between cognitive functioning and SB.

RESULTS

A reduction in grey matter volume in the frontal area, temporal gyrus, precuneus, uncus, amygdala, left cuneus and subcallosal gyrus as well as a marked regional volume reduction in the right hemisphere was linked with the presence of SB. Additionally, worse global cognitive functioning and living in urban areas were identified as suicide risk factors.

CONCLUSIONS

This study provides some insights about the brain abnormalities associated with SB in FEP patients. Specifically, the areas reported are involved in important functions related to SB, such as impulsivity, problem solving or responses to pain. Thus, the results confirm the relevant role of cognitive functioning on SB.

摘要

背景

自杀是首发精神病(FEP)患者过早死亡的主要原因之一。对自杀行为(SB)的认识有限,需要新的综合方法来关注 SB 在精神病早期的生物学和认知特征的可能关系。我们旨在研究大量非情感性 FEP 患者的大脑灰质异常与 SB 或自杀风险之间的关系。

方法

我们使用基于体素的形态测量分析对 145 名 FEP 患者进行了研究,以调查与 SB 相关的结构脑异常模式。此外,还进行了双变量和多变量分析,以探讨认知功能与 SB 之间的关系。

结果

额叶、颞叶、楔前叶、钩回、杏仁核、左侧楔叶和胼胝体下区灰质体积减少以及右侧半球明显的区域性体积减少与 SB 的存在有关。此外,较差的整体认知功能和居住在城市地区被确定为自杀风险因素。

结论

本研究提供了一些关于 FEP 患者与 SB 相关的大脑异常的见解。具体而言,报告的区域涉及与 SB 相关的重要功能,如冲动、解决问题或对疼痛的反应。因此,结果证实了认知功能对 SB 的重要作用。

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