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Illness‐course modulates suicidality‐related prefrontal gray matter reduction in women with bipolar disorder
Author(s) -
Lijffijt M.,
Rourke E. D.,
Swann A. C.,
ZuntaSoares G. B.,
Soares J. C.
Publication year - 2014
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12314
Subject(s) - impulsivity , bipolar disorder , psychiatry , suicide attempt , aggression , psychology , prefrontal cortex , family history , clinical psychology , medicine , poison control , injury prevention , mood , cognition , emergency medicine
Objective Explore interrelationships between suicide attempt history (Objective 1) or suicide attempt severity (Objective 2) with prefrontal cortex gray matter ( PFC GM ) volume and illness‐course in patients with bipolar disorder ( BD ). Method Ninety‐three women with BD ‐I or ‐ II diagnosis (51 with and 42 without suicide attempt history) underwent structural MRI and filled out questionnaires. Measured were GM volumes of 11 PFC regions, BD illness‐course, and attempt history and severity. Effects were examined with repeated measures GLM or logit analyses. Results Objective 1: Attempt history was associated with increased trait impulsivity and aggression, and higher prevalence of BD ‐I, past drug use disorder, and past psychiatric hospitalization. PFC GM volume was lower in patients with than without attempt history in those with past psychiatric hospitalization. PFC GM volume was higher in patients with than without attempt history in those without hospitalization. Higher trait aggression predicted attempt history. Objective 2: Increased frontal pole volume and younger age at first hospitalization predicted many suicide attempts. Conclusion Attempt history in patients with BD related to PFC GM volume reduction or increase. Volume modulation by psychiatric hospitalization could reflect effects of illness‐course or care. Attempt severity was not related to volume reduction. Research on suicidality–brain relationships should include illness‐course and attempt severity measures.