Brain Differences Point To Fatal Suicide Attempt

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Brain Differences Point To Fatal Suicide Attempt

Brain differences point to fatal suicide attempt Reduced brain function in the prefrontal cortex (PFC) of some depressed patients may make them more likely to make a fatal suicide attempt, researchers report in the Archives of General Psychiatry.

Decreased serotonergic function, as measured by a more blunted prolactin response to fenfluramine hydrochloride, has previously been demonstrated in psychiatric patients who attempt suicide, particularly among those whose attempts tend to be lethal, note Maria Oquendo (Columbia University, New York, USA) and colleagues.

To ascertain whether this serotonin hypofunction is related to certain areas of the brain, the researchers compared changes in regional cerebral uptake of fludeoxyglucose (rCMRglu) in 16 depressed patients with a history of potentially lethal suicide attempts and in 9 patients whose attempts were less severe. Brain responses were measured before and after fenfluramine administration.

More lethal suicide attempts were associated with lower rCMRglu response in the ventral, medial, and lateral PFC of the patients than low-lethality suicide attempts. Furthermore, the difference was more pronounced after fenfluramine administration, reflecting a lower response to serotonin among the lethal suicide attempters, for whom levels are already very low.

Patients who were most at risk of attempting a potentially fatal suicide also tended to be older, less impulsive, and more intent on ending their lives, factors which correlated with a lower rCMRglu response, while greater impulsivity and younger age were associated with a higher rCMRglu response.

Oquendo et al say that the introduction of more specific brain scanning techniques may provide a future tool for screening patients at risk of fatal suicidal behavior.

Arch Gen Psychiatry 2003; 60: 14�22

http://www.psychiatrymatters.md/news/2003/week_05/day_4/p_0000052873.asp

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