MRI correlates of suicide attempt history in unipolar depression

Background: Suicide represents a major health problem in the United States, and prediction of suicide attempts is difficult. No structural neuroimagin g studies have been done to specifically examine findings in patients who h ave attempted suicide. The objective of this study was to compare MRI findi ngs in unipolar patients with and without a history of a suicide attempt. Methods: In this post hoc analysis, 20 unipolar subjects with a history of a suicide attempt were matched by age and gender to unipolar subjects witho ut a history of an attempt. Subjects were also matched on parameters such a s cardiovascular history, electroconvulsive treatment history, and history of psychosis. Subjects with a history of any neurologic condition were excl uded. There were no significant differences in age of onset of depression, number of episodes of depression, and Hamilton Depression scores between th e two groups. T2-weighted magnetic resonance imaging (MRI) scans were rated rising the Coffey and Boyko, rating scales. Results: Unipolar patients with a history of a suicide attempt demonstrated significantly more subcortical gray matter hyperintensities compared with patients without such a history. Conclusions: Patients with abnormal MRI findings may be at higher risk for mood disorders and suicide attempts because of disruption of critical neuro anatomic pathways. Gray matter hyperintensities in the basal ganglia may be especially associated with risk for suicide attempts. (C) 2001 Society of Biological Psychiatry.