抑郁症自杀未遂患者血清脑源性神经营养因子水平的变化

目的探讨血清脑源性神经营养因子（BDNF）水平与抑郁症患者自杀行为的关系。方法采用酶联免疫分析实验测定抑郁症自杀未遂患者（36例）、无自杀行为患者（55例）及36名正常对照血清BDNF水平,对抑郁症患者以汉密尔顿抑郁量表（HAMD）评定抑郁症状,以自杀意念自评量表（SIOSS）评定自杀意念的强烈程度。结果抑郁症患者组血清BDNF水平低于正常对照组（P〈0．01）。自杀未遂组血清BDNF水平低于无自杀组及正常对照组（P〈0．01）。自杀未遂组HAMD总分和SIOSS总分高于无自杀组。抑郁症患者血清BDNF水平与SIOSS总分呈负相关。结论抑郁症患者存在血清BDNF降低,BDNF水平可能是自杀倾向行为的生物学标志。     

抑郁症患者自杀的危险因素研究

目的:探讨抑郁症患者自杀的危险因素及生物学指标.方法:以抑郁症患者入院时有无自杀行为分为自杀组和无自杀组.用汉密尔顿抑郁量表(HAMD,24项)、生活事件量表(LES)及自行编制的自杀行为调查表对入组患者进行调查;酶法测定两组患者的总胆固醇(CHO)、三酰甘油(TG)、高密度脂蛋白(HDL-C)和低密度脂蛋白(LDL-C)水平.结果:共107例.多因素Logistic回归分析发现,自杀与既往自杀行为、内向性格、生活事件、严重的抑郁(尤其是绝望感明显,存在严重的认识障碍)有关;两组的血脂水平差异无显著.结论:既往自杀行为、内向性格、生活事件、严重的抑郁是抑郁症患者自杀的主要危险因素;抑郁症患者的自杀可能与血脂水平无关.     

抑郁症自杀未遂患者血清总胆固醇水平研究

目的:对抑郁症自杀未遂患者的血清胆固醇水平与自杀行为的关系进行研究。方法:对抑郁症患者进行血清胆固醇水平测定,其中伴自杀未遂行为者26例,不伴自杀行为者32例,以正常健康者30名为对照。结果:抑郁症伴自杀未遂行为组血清胆固醇水平明显低于无自杀行为组和正常对照组。血清胆固醇水平与自杀的严重程度呈明显负相关。结论:低血清胆固醇水平可增加抑郁症自杀的风险。推测低血清胆固醇导致的自杀行为可能与中枢5-羟色胺(5-HT)功能降低有关。     

低血清胆固醇与女性抑郁症的自杀行为

目的　本文对女性抑郁症患者的血清胆固醇水平与自杀行为的关系进行了探讨。方法　对 116例样本进行血清胆固醇水平测定 ,其中抑郁症伴自杀行为的 40例 ,抑郁症不伴自杀行为的 3 6例 ,正常人 40例。结果　抑郁症伴有自杀行为组血清胆固醇水平明显低于无自杀行为组和正常对照组。血清胆固醇水平与自杀的严重程度呈明显相关。结论　我们认为低血清胆固醇水平可增加女性抑郁症自杀的风险。推测低血清胆固醇导致的自杀行为可能与中枢 5 羟色胺 ( 5 HT)功能降低有关。     

抑郁发作自杀未遂患者脑源性神经营养因子水平及其相关因素研究

目的 探讨脑源性神经营养因子(BDNF)在抑郁发作自杀未遂者中的可能作用.方法 对抑郁发作自杀未遂患者(自杀未遂组,23例)和抑郁发作无自杀行为患者(无自杀组,24例)采用汉密尔顿抑郁量表(24项,HAMD24)、Beck绝望量表(BHS)和自杀意念自评量表(SIOSS)评定抑郁严重程度、绝望程度及自杀意图的强烈程度;采用酶联免疫吸附法测定其血清BDNF浓度,并与正常对照者(对照组,30名)比较;对自杀未遂组的血清BDNF浓度与各相关因素进行Pearson相关分析.结果 (1)自杀未遂组的HAMD24[(37.8±8.7)分]、BHS[(13.0±3.8)分]及SIOSS评分[(18.1±3.9)分]均高于无自杀组[分别为(26.0±6.0)分、(7.5±4.3)分、(12.0±4.0)分;P<0.01].(2)自杀未遂组的BDNF平均浓度[(57 ±16)ng/L]低于无自杀组[(75 ±28)ng/L;P<0.05],无自杀组的BDNF平均浓度亦低于正常对照组[(111±39)ng/L;P<0.01].(3)自杀未遂组的血清BDNF浓度与抑郁发作的病程(r=-0.541)、BHS总分(r=-0.494)、SIOSS总分(r=-0.754)呈负相关(P<0.01-0.05).结论 低水平的BDNF可能是抑郁发作自杀未遂的一个危险因素.     

精神分裂症自杀未遂者脑源性神经营养因子研究

目的:探讨影响精神分裂症自杀未遂患者脑源性神经营养因子(BDNF)水平的相关因素。方法:采用横断面病例-对照研究设计。研究包括精神分裂症自杀未遂组20例,精神分裂症无自杀行为组28例,正常对照组30名。采用酶联免疫吸附试验法测定血清BDNF浓度。采用简明精神病评定量表(BPRS)和自杀意图自评量表(SIOSS)对患者组进行评定。比较各组BDNF水平及其与相关因素之间的关系。结果:三组间BDNF水平差异有统计学意义(F=32.395,P<0.01)。Post-hoc分析发现,精神分裂症自杀未遂组BDNF水平[(51.3±11.1)pg/ml]显著低于精神分裂症无自杀行为组[(67.7±20.8)pg/ml](P<0.05),而精神分裂症无自杀行为组BDNF水平也低于正常对照组[(111.3±39.0)pg/ml](P<0.01)。自杀未遂组的血清BDNF水平与自杀严重程度呈负相关(r=-0.836,P<0.01)。结论:精神分裂症自杀未遂患者BDNF水平低于精神分裂症无自杀行为患者和正常人群;BDNF可能是参与精神分裂症自杀病理生理机制的一种重要物质。     

抑郁症患者自杀危机管理

目的探讨抑郁症患者自杀危机管理方法及效果。方法 90例抑郁症患者根据平行对照法分为观察组与对照组各45例,2组均接受抗抑郁药物治疗及常规护理干预,观察组则接受自杀危机管理,治疗结束后观察2组HAMD(汉密顿抑郁量表)评分改善情况,并记录2组干预后自杀行为发生情况。结果观察组干预后HAMD评分明显低于对照组(P0.05);观察组自杀行为发生明显少于对照组(P0.05)。结论通过对抑郁症患者的自杀危机管理能够改善患者抑郁情况,有助于减少患者的自杀行为。     

5-羟色胺和胆固醇水平对抑郁症患者再次自杀风险评估的研究

目的 探讨抑郁症患者血小板5-羟色胺（5-HT）和胆固醇水平与抑郁症患者再次自杀的关系.方法 对33例有自杀行为的抑郁症患者在接受治疗前测定血小板5-HT和胆固醇水平,评定汉密尔顿抑郁量表（HAMD-24）和Beck绝望量表（BHS）,然后进行2年的随访.结果 16例患者再次出现自杀行为,再次自杀组血小板5-HT及血清胆固醇水平显著低于无再次自杀组（P＜0.01）.5-HT和血清胆固醇水平与HAMD-24、BHS分及自杀次数、自杀严重程度均呈负相关（P＜0.01）,且5-HT与血清胆固醇水平呈正相关（P＜0.01）.多重回归分析显示血小板5-HT浓度、家族史是自杀次数的主要影响因素.结论 低血小板5-HT及血清胆固醇浓度是抑郁症自杀的危险因素,对抑郁症自杀行为可能具有一定的的预测作用.     

抑郁症患者自杀行为与色氨酸羟化酶基因及单胺氧化酶A基因多态性的关联研究

目的:探讨抑郁症患者自杀行为与色氨酸羟化酶(TPH)、单胺氧化酶A(MAOA)基因多态性的相关性. 方法:符合中国精神障碍分类与诊断标准第3版抑郁症诊断标准患者212例,汉密尔顿抑郁量表评分≥17分,其中64例患者有自杀或自杀未遂行为(有自杀行为组),148例患者无自杀行为(无自杀行为组).采用聚合酶链式反应扩增及限制性片段长度多态性技术检测TPH、MAOA基因多态性,与抑郁症患者自杀行为进行关联分析. 结果:TPH基因型频数和等位基因频率上有自杀行为组与无自杀行为组差异有统计学意义(x2=6.058,P=0.048;x2=4.774,P=0.029),有自杀行为组A/A基因型和等位基因A频率分布显著高于无自杀行为组(P＜0.05).MAOA基因型频数和等位基因频率上有自杀行为组与无自杀行为组差异无统计学意义(x2=0.922,0.898;P均＞0.05). 结论:TPH基因多态性与抑郁症患者的自杀行为存在关联,MAOA基因多态性与抑郁症患者自杀行为可能无关联.     

血清总胆固醇及其低、高密度脂蛋白胆固醇的水平下降与抑郁症患者自杀行为的关系

目的 本文对抑郁症患者的血清胆固醇(TC)及高密度脂蛋白胆固醇(HDI)及低密度脂蛋白胆固醇(LDL)的水平与自杀行为的关系进行了探讨。方法 对107例样本进行了上述测定，其中病例组67例，抑郁症伴自杀行为者33例，无自杀行为者34例，正常对照组40例。结果 抑郁症伴有自杀行为者TC及LDL明显低于无自杀行为者和正常对照组，而HDI与无自杀行为者和正常对照组无明显差异。TC及LDL水平与自杀的严重程度呈明显相关。结论 我们认为TC和LDL水平的降低可增加抑郁症患者自杀的风险。     

Serum BDNF levels in suicide attempters related to psychosocial stressors: a comparative study with depression

Although many studies have examined the neurobiological aspects of suicide, the molecular mechanisms and pathophysiologic mechanisms associated with suicide remain unclear. In this study, it is aimed to investigate whether there is a difference in serum brain-derived neurotrophic factor (BDNF) levels among suicide attempters without a major psychiatric disorder, compared to major depressive disorder patients and healthy subjects. It was undertaken with the hypothesis that suicide per se lowers serum BDNF levels, since it is a source of stress. The study was carried out in Celal Bayar University Hospital, Manisa, Turkey. Ten suicide attempters, 24 patients with major depressive disorder and 26 subjects without any psychiatric diagnosis and any psychiatric treatment were included in the study. All subjects were asked to give their written consent. Blood samples were collected at the baseline. Serum BDNF was kept at -70 degrees C before testing, and assayed with an ELISA kit (Promega; Madison, Wisc., USA) after dilution with the block and sample solution provided with the kit. The data were subjected to the Kruskal-Wallis test for nonparametric analysis of variance. Mean serum BDNF levels were significantly lower in the suicide group (21.2 +/- 12.4 ng/ml) and the major depressive disorder group (21.2 +/- 11.3 ng/ml) than the control group (31.4 +/- 8.8 ng/ml; p = 0.004). These results suggest that BDNF may play an important role in the neurobiology of suicidal behavior. BDNF levels may be a biological marker for suicidal behavior. To investigate the role of BDNF in suicide, further studies with a wider sample size and a variety of psychiatric diagnoses accompanying suicide attempt are needed.     

Low plasma BDNF is associated with suicidal behavior in major depression

Brain-derived neurotrophic factor (BDNF), the most abundant neurotrophin in the brain, has a known association with the pathophysiology of anxiety and depression. However, the role of BDNF in suicide has not been well investigated to date. This study examined plasma BDNF levels in 32 major depressive disorder (MDD) patients who had recently attempted suicide, 32 non-suicidal MDD patients, and 30 normal controls. The lethality of the suicide attempt was measured using the Risk-Rescue Rating (RRR) and Lethality Suicide Attempt Rating Scale (LSARS). The severity of depression was measured with the Hamilton Depression Rating Scale (HDRS). Plasma BDNF levels were measured by enzyme linked immunosorbent assay. BDNF levels were significantly lower in suicidal MDD patients (430.5+/-397.0 pg/ml) than non-suicidal MDD patients (875.80+/-663.02 pg/ml) or normal controls (889.4+/-611.3 pg/ml) (F=6.682, p=0.002). The most suitable cut-off point of BDNF level between suicidal depression and non-suicidal depression groups was 444.58 pg/ml. At this cut-off point, the sensitivity=68.7%, specificity=78.1%, positive predictive value=75.9%, and negative predictive value=71.4%. However, there was no significant difference in BDNF levels between the depressive control and normal control groups (p=0.996). LSARS and RRR did not reveal any significant correlations with BDNF levels in suicidal patients. In addition, BDNF levels were not different between fatal and non-fatal suicide attempts. These results suggest that reduction of plasma BDNF level is related to suicidal behavior in major depression and that BDNF level may be a biological marker of suicidal depression.     

Potential peripheral biological predictors of suicidal behavior in major depressive disorder

Previous studies have shown that dysfunctions in the serotonin system and hypothalamic-pituitary-adrenal axis (HPA) are associated strongly with suicidal behavior and suicide, especially among individuals with major depressive disorder. Suicidal behavior has been explained using both the stress-diathesis model and the state-trait interaction model. Specifically, diatheses, or trait-dependent risk factors, are associated with dysfunctions in the serotonin system; however, stress responses, or state-dependent factors, are associated with HPA hyperactivity. Decreases in cholesterol and brain-derived neurotrophic factor (BDNF) levels have been associated with impaired brain plasticity among individuals with suicidal behavior. Decreased serotonin functioning has been measured using cerebral spinal fluid (CSF) 5-HIAA, fenfluramine challenge studies, and platelet 5-HT2A receptors. HPA axis dysfunction has been evaluated with the dexamethasone suppression test. Cholesterol and BDNF levels have been measured in blood serum or plasma.Nevertheless, challenges to finding promising and accessible neurobiological predictors of suicide and suicidal behavior remain. As suicide behavior is a complex phenomenon, a combined or multidimensional approach, including each of the aforementioned methods, may be required to predict suicide risk among individuals with major depressive disorder.     

Increased plasma nitric oxide level associated with suicide attempt in depressive patients

BACKGROUND: Nitric oxide (NO) is known to influence cerebral monoaminergic activity, including the activity of serotonin. We evaluated plasma NO metabolite (NO(x)) levels in depressive patients with and without a recent history of suicide attempt. METHOD: Plasma NO(x) levels were measured in 39 depressive patients who had recently attempted suicide, 44 non-suicidal depressed patients, and 70 normal controls. The severity of depression was measured with the Hamilton's Depression Rating Scale. The lethality of the suicide attempt was scored using Weisman and Worden's risk-rescue rating scale and Lethality Suicide Attempt Rating Scale. RESULTS: Plasma NO(x) levels were significantly higher in suicidal depressive patients than non-suicidal depressive patients or normal control subjects (Z=-2.472, p=0.013). However, higher plasma NO(x) levels in suicidal depressive patients were significantly related to a lower lethality of suicide attempts and lower severity of depression. CONCLUSIONS: Our study suggests that increased plasma NO(x) level is associated with suicide attempts in depressive patients. Moreover, higher plasma NO(x) level is related with suicide attempts in mild depressed patients. However, further studies are required to understand the role of NO system in depression and suicidal behavior.     

Association of comorbid posttraumatic stress disorder and major depression with greater risk for suicidal behavior

OBJECTIVE: Posttraumatic stress disorder (PTSD) increases the risk of suicidal behavior; a major depressive episode also increases the risk for suicidal behavior. The authors' goal was to examine the effect of comorbid PTSD and major depressive episode on suicidal behavior. METHOD: Inpatients with a diagnosis of major depressive episode (N=156) were assessed for PTSD, suicidal behavior, and clinical risk factors for suicidal acts. RESULTS: Patients with comorbid major depressive episode and PTSD were more likely to have attempted suicide, and women with both disorders were more likely to have attempted suicide than men with both disorders. Cluster B personality disorder and PTSD were independently related to history of suicide attempts. CONCLUSIONS: The greater rate of suicide attempts among patients with comorbid PTSD and major depressive episode was not due to differences in substance use, childhood abuse, or cluster B personality disorders.