Roy A
Department of Psychiatry, University of Medicine and Dentistry of New Jersey.
Suicide Life Threat Behav. 1994 Spring;24(1):10-4.
This paper selectively reviews the author's recent studies on suicidal behavior in depression. Data are reviewed from a study of depressed patients who had monoamine metabolites measured in both the cerebrospinal fluid (CSF) and urine. Depressed patients who had attempted suicide had significantly reduced CSF concentrations of the dopamine metabolite homovanillic acid (HVA) and significantly lower urinary outputs of HVA than patients who had not attempted suicide. Similarly, patients who went on to reattempt suicide over a 5-year follow-up period had both significantly reduced CSF concentrations of HVA and lower urinary outputs of HVA than patients who did not reattempt. These data suggest a role for diminished central dopaminergic neurotransmission in suicidal behavior in depression. Patients who had made a violent suicide attempt also showed evidence of dysregulation of the hypothalamic-pituitary-adrenal axis.
本文选择性地回顾了作者近期关于抑郁症自杀行为的研究。数据来自一项对抑郁症患者的研究，这些患者的脑脊液（CSF）和尿液中均检测了单胺代谢物。与未尝试自杀的抑郁症患者相比，尝试过自杀的抑郁症患者脑脊液中多巴胺代谢物高香草酸（HVA）的浓度显著降低，且HVA的尿排出量也显著更低。同样，在5年随访期内再次尝试自杀的患者，其脑脊液中HVA的浓度和HVA的尿排出量均显著低于未再次尝试自杀的患者。这些数据表明，中枢多巴胺能神经传递减弱在抑郁症自杀行为中起作用。有过暴力自杀企图的患者还表现出下丘脑 - 垂体 - 肾上腺轴调节异常的证据。
