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Fronto-limbic brain structures in suicidal and non-suicidal female patients with major depressive disorder

Molecular Psychiatry volume 12, pages 360–366 (2007)Cite this article

Abstract

Our knowledge about the neurobiology of suicide is limited. It has been proposed that suicidal behavior generally requires biological abnormalities concomitant with the personality trait of impulsivity/aggression, besides an acute psychiatric illness or psychosocial stressor. We investigated fronto-limbic anatomical brain abnormalities in suicidal and non-suicidal adult female patients with unipolar depression. Our sample consisted of seven suicidal unipolar patients, 10 non-suicidal unipolar patients and 17 healthy female comparison subjects. The criterion for suicidality was one or more documented lifetime suicide attempts. A 1.5T GE Signa Imaging System running version Signa 5.4.3 software was used to acquire the magnetic resonance imaging images. All anatomical structures were measured blindly, with the subjects’ identities and group assignments masked. We used analysis of covariance with age and intracranial volume as covariates and the Tukey–Kramer procedure to compare suicidal patients, non-suicidal patients and healthy comparison subjects. Suicidal patients had smaller right and left orbitofrontal cortex gray matter volumes compared with healthy comparison subjects. Suicidal patients had larger right amygdala volumes than non-suicidal patients. Abnormalities in the orbitofrontal cortex and amygdala in suicidal patients may impair decision-making and predispose these patients to act more impulsively and to attempt suicide.

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Acknowledgements

This work was partly supported by American Foundation for Suicide Prevention, MH 01736, MH 30915, RR020571, NARSAD, the Krus Endowed Chair in Psychiatry (University of Texas Health Science Center at San Antonio), Veterans Administration (VA Merit Review), CAPES Foundation (Brazil), CNPq (Brazil). We thank Ellen Frank, PhD and David Kupfer, MD from Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA, USA, for their invaluable help and support in patient recruitment.

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Authors and Affiliations

  1. Department of Psychiatry, MOOD-CNS Program (Mood Disorders Clinical Neurosciences Program), The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    E S Monkul, J P Hatch, M A Nicoletti, S Spence & J C Soares

  2. Audie L Murphy Division, South Texas Veterans Health Care System, San Antonio, TX, USA

    E S Monkul & J C Soares

  3. Department of Psychiatry, Dokuz Eylül University School of Medicine, Izmir, Turkey

    E S Monkul

  4. Deparment of Orthodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    J P Hatch

  5. Department of Pathology and Experimental and Clinical Medicine, Section of Psychiatry, University of Udine, Udine, Italy

    P Brambilla

  6. Scientific Institute IRCCS E Medea, Pasian di prato, Udine, Italy

    P Brambilla

  7. Department of Psychiatry, Interdisciplinary Lab of Neuroimaging and Cognition (LiNC), Federal University of Sao Paulo, Sao Paulo, Brazil

    A L T Lacerda

  8. Institute of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil

    R B Sassi

  9. Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    A G Mallinger

  10. Department of Psychiatry and Behavioral Sciences, Wayne State School of Medicine, Detroit, MI, USA

    M S Keshavan

  11. Department of Radiology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    J C Soares

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  1. E S Monkul
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  2. J P Hatch
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  7. R B Sassi
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Correspondence to J C Soares.

Additional information

Previous presentations: Society of Biological Psychiatry Annual Meeting, April 29th–May 1st, 2004, NY, USA and 18th ECNP Congress, October 22–26, 2005, Amsterdam, The Netherlands.

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Monkul, E., Hatch, J., Nicoletti, M. et al. Fronto-limbic brain structures in suicidal and non-suicidal female patients with major depressive disorder. Mol Psychiatry 12, 360–366 (2007). https://doi.org/10.1038/sj.mp.4001919

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  • DOI: https://doi.org/10.1038/sj.mp.4001919

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