Orygen, Parkville, VIC, Australia.
Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.
Mol Psychiatry. 2022 Nov;27(11):4550-4560. doi: 10.1038/s41380-022-01734-0. Epub 2022 Sep 7.
Identifying brain alterations associated with suicidal thoughts and behaviors (STBs) in young people is critical to understanding their development and improving early intervention and prevention. The ENIGMA Suicidal Thoughts and Behaviours (ENIGMA-STB) consortium analyzed neuroimaging data harmonized across sites to examine brain morphology associated with STBs in youth. We performed analyses in three separate stages, in samples ranging from most to least homogeneous in terms of suicide assessment instrument and mental disorder. First, in a sample of 577 young people with mood disorders, in which STBs were assessed with the Columbia Suicide Severity Rating Scale (C-SSRS). Second, in a sample of young people with mood disorders, in which STB were assessed using different instruments, MRI metrics were compared among healthy controls without STBs (HC; N = 519), clinical controls with a mood disorder but without STBs (CC; N = 246) and young people with current suicidal ideation (N = 223). In separate analyses, MRI metrics were compared among HCs (N = 253), CCs (N = 217), and suicide attempters (N = 64). Third, in a larger transdiagnostic sample with various assessment instruments (HC = 606; CC = 419; Ideation = 289; HC = 253; CC = 432; Attempt=91). In the homogeneous C-SSRS sample, surface area of the frontal pole was lower in young people with mood disorders and a history of actual suicide attempts (N = 163) than those without a lifetime suicide attempt (N = 323; FDR-p = 0.035, Cohen's d = 0.34). No associations with suicidal ideation were found. When examining more heterogeneous samples, we did not observe significant associations. Lower frontal pole surface area may represent a vulnerability for a (non-interrupted and non-aborted) suicide attempt; however, more research is needed to understand the nature of its relationship to suicide risk.
识别与年轻人自杀意念和行为（STB）相关的大脑改变对于理解其发展以及改善早期干预和预防至关重要。ENIGMA 自杀意念和行为（ENIGMA-STB）联盟分析了跨站点协调的神经影像学数据，以检查与年轻人 STB 相关的大脑形态。我们在三个独立的阶段进行了分析，这些阶段的样本在自杀评估工具和精神障碍方面从最同质到最不同质。首先，在一个有心境障碍的 577 名年轻人样本中，使用哥伦比亚自杀严重程度评定量表（C-SSRS）评估 STB。其次，在一个有心境障碍的年轻人样本中，使用不同的工具评估 STB，在没有 STB 的健康对照组（HC；N=519）、没有 STB 的心境障碍但临床对照组（CC；N=246）和有当前自杀意念的年轻人（N=223）之间比较 MRI 指标。在单独的分析中，在 HC（N=253）、CC（N=217）和自杀未遂者（N=64）之间比较 MRI 指标。第三，在一个有各种评估工具的更大的跨诊断样本中（HC=606；CC=419；意念=289；HC=253；CC=432；尝试=91）。在同质的 C-SSRS 样本中，有心境障碍和既往实际自杀未遂（N=163）的年轻人的额极表面积低于无终生自杀未遂（N=323）的年轻人（FDR-p=0.035，Cohen's d=0.34）。没有发现与自杀意念的关联。当检查更异质的样本时，我们没有观察到显著的关联。较低的额极表面积可能代表了（非中断和非中止）自杀未遂的易感性；然而，需要更多的研究来理解其与自杀风险的关系本质。
