MedicalResearch.com Interview with:
Maria A. Oquendo, M.D.
Professor of Psychiatry
Vice Chair for Education
Columbia University Medical Center
American Psychiatric Association, President
International Academy of Suicide Research, President
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our team has worked for years on identifying the biological underpinnings of both risk for suicidal behavior (SB) and for predicting the lethality or medical consequences of suicidal behavior. We have shown that if you compare those who are depressed and have had SB to those who are depressed but do not have suicidal behavior, you can see clear differences in the serotonin system using Positron Emission Tomography and a molecule tagged with radioactivity. We predicted that if you could see these differences cross-sectionally, then their presence might also predict suicidal behavior and its lethality in the future. Our study showed that those with higher serotonin 1a binding in the raphe nuclei, which likely indicates low serotonin functioning, made more medically damaging suicide attempts in the two years that followed. They also suffered from more pronounced suicidal ideation in the subsequent year.
MedicalResearch.com: What should readers take away from your report?
Response: Suicidal behavior is not simply a reaction to stressors. Some individuals are vulnerable to reacting to stress based on biological brain characteristics that could be in the serotonin system, as this study illustrates, or in the hypothalamic-pituitary-adrenal axis.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We are starting an exciting new study to follow up on this and other findings from our laboratory. In our current study, we seek to delineate two different phenotypes of suicidal behavior.
One is a more stress-reactive, impulsive suicidal behavior that may be more prevalent in those depressed individuals with a dysregulated hypothalamic-pituitary-adrenal axis.
The other might be a more planned SB occurring in those with more persistent suicidal ideation and with abnormalities of the serotonin system.
MedicalResearch.com: Is there anything else you would like to add?
Response: While we cannot yet use these methods to identify particular individuals at risk, studies like this one gets us closer to identifying clinically useful biomarkers for suicide risk.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Oquendo MA, Galfalvy H, Sullivan GM, et al. Positron Emission Tomographic Imaging of the Serotonergic System and Prediction of Risk and Lethality of Future Suicidal Behavior. JAMA Psychiatry. Published online July 27, 2016. doi:10.1001/jamapsychiatry.2016.1478.
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