PSYCHOBIOLOGICAL PREDICTORS OF SUICIDAL BEHAVIOR IN MDE

MDE 自杀行为的心理生物学预测因素

• 批准号: 2248188
• 负责人: Joseph John Mann
• 金额: $ 13.44万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-05-01 至 1997-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2248188
• 关键词: antidepressants; behavior prediction; drug abuse; family; fenfluramine; human subject; interview; longitudinal human study; major depression; mental disorder diagnosis; personality tests; psychobiology; serotonin; social support network; suicide; type A /type B personality

Although suicide and suicide attempts have long been known to be associated with "depression", most studies of this association have suffered from methodologic flaws, e.g., retrospective diagnostic assessments, unreliable diagnostic categories, mixed diagnostic samples or the equally serious drawback of having focused on one or other domain of potential predictor variables. The present study will employ structured clinical interviews for diagnosis according to the DSM-III-R criteria. A cohort of 200 hospitalized patients with Major Depressive Episodes (135 attempters, 65 non-attempters) will receive extensive diagnostic, behavioral and biological assessments. These patients will be studied in a cross- sectional manner as part of the NIMH-funded Clinical Research Center for the Study of Suicidal Behavior at the University of Pittsburgh. This study now seeks to conduct a prospective study of outcome in this unique cohort of patients with regard to suicidal behavior. Patients will be reassessed for clinical state, life events and suicidal behavior 3 months, 12 months and 24 months after discharge. This will be the first such comprehensive psychobiological, prospective study of predictors of suicidal behavior. Since, determinants of suicidal behavior are derived from multiple domains including psychopathologic, genetic, biologic, psychologic, familial and psychosocial, the development of a general explanatory or predictive model of suicidal behavior or completed suicide is dependent on the simultaneous assessment of potential risk factors from multiple domains in the same patient population. The testing of such a predictive model for suicidal behavior requires a prospective follow-up study such as the one proposed here. The major hypotheses of the present study are that the presence of a major depressive disorder, clinical behavior dimensions (e.g., hopelessness, substance abuse), life events and biological measures (CSF 5- HIAA, prolactin response to fenfluramine, platelet 5-HT2 receptors) will hypotheses is that the depressive episode, behavioral dimensions, biological indices, and treatment intensity will vary in terms of being state or trait-dependent and short or long-term predictors and that predictors of high medical damage and planned suicide attempts will differ from predictors of impulsive, low medical damage attempts. Exploratory studies will involve testing predictors of suicide completers and a comparison will be made of predictors of high and low planning, medical damage suicide reattempts versus completion.

尽管长期以来已知自杀和自杀企图是相关的 有了“抑郁”，大多数研究都遭受了 方法论缺陷，例如回顾性​​诊断评估，不可靠 诊断类别，混合诊断样本或同样严重的 专注于一个或其他潜在预测指标领域的缺点 变量。 本研究将采用结构化的临床访谈 根据DSM-III-R标准进行诊断。 200个队列 住院的主要抑郁发作患者（135例，65例 非主题）将获得广泛的诊断，行为和 生物评估。 这些患者将在交叉中进行研究 作为NIMH资助的临床研究中心的一部分，分区方式 匹兹堡大学自杀行为的研究。 这项研究 现在试图在这个独特的队列中对结果进行前瞻性研究 关于自杀行为的患者。 患者将重新评估 对于临床状态，生命事件和自杀行为3个月，12个月 出院后24个月。 这将是第一个如此全面的 心理生物学，前瞻性研究自杀行为的预测指标。 由于自杀行为的决定因素来自多个领域 包括心理病理学，遗传学，生物学，心理学，家族性和家族性 心理社会，发展一般解释或预测模型 自杀行为或自杀的自杀性取决于同时 评估来自多个领域的潜在危险因素 患者人数。 自杀的预测模型的测试 行为需要一项前瞻性后续研究，例如提出的一项研究 这里。 本研究的主要假设是 主要抑郁症，临床行为维度（例如， 绝望，滥用药物），生活事件和生物学措施（CSF 5- HIAA，催乳素对富氟拉明，血小板5-HT2受体的反应）将 假设是抑郁发作，行为维度， 生物指数和治疗强度在存在方面会有所不同 状态或特质依赖性以及短期或长期预测因素，并且 高医疗损害和计划自杀未遂的预测因素将有所不同 来自冲动，医疗损害低的预测因素。 探索性 研究将涉及测试自杀完成者的预测因子和 比较将与高计划，医疗的预测指标进行比较 损害自杀的重新分配与完成。