White Matter Hyperintensities and Their Associations With Suicidality in Psychiatrically Hospitalized Children and Adolescents

• NCJ Number: 205766
• Journal: Child & Adolescent Psychiatry Volume: 43 Issue: 6 Dated: June 2004 Pages: 770-776
• Author(s): Stefan Ehrlich B.Sc.; Gil G. Noam Ed.D.; In Kyoon Loo M.D.; Bae J. Kwon M.D.; Megan A. Clark M.A.; Perry F. Renshaw M.D.
• Date Published: June 2004
• Length: 7 pages
• Sponsoring Agency: Esther A and Joseph Klingenstein Fund; American Foundation for Suicide Prevention (AFSP)
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study compared white matter hyperintensities in psychiatrically hospitalized children and youth with and without a history of suicide attempts while controlling for other variables.

Abstract

In the past several years, the technology for neuroimaging has vastly improved. Consequently, some authors have already begun to speculate about whether there is enough evidence to incorporate new neuroimaging findings into clinical practice and into the DSM-IV mood disorder classification system. The strong associations between so-called white matter hyperintensities (WMH) and unipolar and bipolar disorders were confirmed by several working groups. In the current study, the sample population consisted of 153 child and adolescent psychiatric patients admitted to a typical child and adolescent psychiatry inpatient unit of a major private psychiatric hospital. They had clinical MRI brain scans at the brain imaging center between 1993 and 2000. The sample was rated on T2-weighted magnetic resonance imaging scan by using a modified Coffey scale. Discharge medical records were examined to determine DSM-IV diagnosis, history of suicide attempts, and control variables such as gender, age, comorbid medical illnesses, developmental disorders, substance abuse, severity of mental illness, head injury, and possible cerebral hypoxia. The study found that within the unipolar depression group (n=48) WMH was significantly associated with a higher prevalence of past suicide attempts. Logistic regression analysis confirmed this relationship; none of the control variables confounded the results. This study thus shows for the first time that unipolar youth with WMH, particularly periventricular hyperintensities (PVH), are apparently more likely to have a history of suicide attempts. These preliminary findings suggest that there might be a marker for a biological process that increases the risk of suicidality. 3 tables and 29 references