Stand der Ursachen - Mitteldeutsche Psychiatrietage 2011

Poster | Affektive Störungen
P18
Altered brain structures in suicidal patients with major depressive disorder
G. Wagner, Jena
Introduction: Among others one major factor for mortality in major depressive disorder (MDD) is the
considerably increased risk for suicide, which is up to 17 times higher in people with mood disorders than
in the general population. However, it does not fully explain why most people with mood disorders never
attempt suicide. This indicates that a predisposition to suicidal behavior may exist which is independent of
the disorder itself. Furthermore, suicide attempters with mood disorders have between a 1.5-fold and
sixfold higher rate of suicidal behavior in first-degree relatives than non-suicidal depressed patients. Both
genetic and nongenetic factors may play a role in the familial transmission of the diathesis for suicidal
behavior. One of these transmission factors may be neurobiological alterations. The majority of previous
studies regarding neurobiology of suicidal behavioral reported neurochemical alterations in the serotonin
transmission in terms of decreased serotonin availability, which might lead to aggressive and impulsive
behavioral. The main goal of the present study was to study hypothesized anatomical abnormalities in the
fronto-limbic network in depressed patients with a history of a suicide attempt and/or suicide in firstdegree
relative as a susceptibility factor for suicide in contrast to non-suicidal patients with MDD.
Methods: 15 patients with MDD and documented suicide attempt and/or suicide in first-degree relatives,
15 non-suicidal depressed patients and 30 matched healthy controls participated in the study. We applied
an optimized voxel-based morphometry (VBM) protocol to high-resolution structural T1-weighted volume
scans (1mm³ resolution) using the VBM-toolbox as implemented in the SPM2 package.
Results and Discussion: Suicidal patients showed significantly decreased gray matter density in anterior
cingulate, hippocampus and caudate in contrast to matched healthy controls and non-suicidal patients.
This new finding provides evidence for structural brain alterations in suicidal depressed patients in a brain
network strongly involved in emotional and motivational control.
8. Mitteldeutsche Psychiatrietage | 80