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White matter hyperintensities and their associations with suicidality in patients with major affective disorders

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Abstract

Introduction

A large body of evidence suggests that predisposition to suicide, an important public health problem, is mediated to a certain extent by neurobiological factors. The objective of this cross-sectional study was to compare the prevalence of white matter hyperintensities (WMH) in patients with major affective disorders with and without histories of suicide attempts.

Methods

T2-weighted magnetic resonance images (MRI) of 65 psychiatric inpatients with major depressive disorder or bipolar disorder were rated for the presence of WMH. Diagnoses, presence or absence of suicide risk and substance abuse were determined by the Mini International Neuropsychiatric Interview (MINI). Medical charts were reviewed to ascertain history of suicide attempt and basic clinical variables. Fisher’s Exact Tests and logistic regression modeling were used to test the association between WMH and suicidality. Suicidal patients and controls were not matched for demographic variables and exposure to some risk factors.

Results

Bivariate analysis showed that the prevalence of WMH was significantly higher in subjects with past suicide attempts (Fisher’s Exact Test, p = 0.01) and other clinical indicators of elevated suicide risk. Logistic regression analyses controlling for age, sex, and several clinical risk factors supported this finding (odds ratio = 4.7; 95% confidence interval: 1.4, 16.1).

Conclusions

The increased prevalence of WMH in adults with major affective disorders and a history of suicide attempt, compared to similar patients without such a history, is consistent with previous findings in depressed children, youth and young adults. However, the association between WMH and suicidality holds true for both, depressed and bipolar patients. Our results suggest that WMH in patients with major affective disorders might be useful biological markers of suicidality.

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Authors and Affiliations

  1. McLean Hospital—Harvard Medical School, Boston, MA, USA

    Maurizio Pompili M.D.

  2. Department of Psychiatry, Sant’Andrea Hospital, University of Rome “La Sapienza”, Via di Grottarossa, 1035, Rome, 00189, Italy

    Maurizio Pompili M.D., Eleonora De Pisa M.D., Andrea Cittadini M.D., Benedetta Montagna M.D., Paolo Iliceto Ph.D., Roberto Tatarelli M.D. & Paolo Girardi M.D.

  3. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany

    Stefan Ehrlich M.D.

  4. Division of Neuroscience, Columbia University, New York State Psychiatric Institute, New York, NY, USA

    J. John Mann M.D.

  5. Università Europea of Rome, Rome, Italy

    Marco Innamorati Psy. D.

  6. Depertment of Neuroscience, Division of Neuroradiology, Sant’Andrea Hospital, University of Rome “La Sapienza”, Rome, Italy

    Andrea Romano M.D.

  7. Department of Neuroscience, Division of Psychiatry, University of Parma, Parma, Italy

    Mario Amore M.D.

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  1. Maurizio Pompili M.D.
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  2. Stefan Ehrlich M.D.
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Correspondence to Maurizio Pompili M.D..

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Pompili, M., Ehrlich, S., De Pisa, E. et al. White matter hyperintensities and their associations with suicidality in patients with major affective disorders. Eur Arch Psychiatry Clin Neurosc 257, 494–499 (2007). https://doi.org/10.1007/s00406-007-0755-x

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  • DOI: https://doi.org/10.1007/s00406-007-0755-x

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