A multicenter study about neurobiology of suicidal behaviour. T. Bronisch, J. Brunner, B. Bondy, D. Rujescu, G. Bischof, I. Heuser, B. Müller-Oerlinghausen, B. Hawellek, W. Maier, M.L. Rao, W.Felber, U. Lewitzka, M. Oehler, A. Brooks, F. Hohagen, E.Lauterbach 3rd International Symposium
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neurobiology of suicidal behaviour
T. Bronisch, J. Brunner, B. Bondy, D. Rujescu, G. Bischof, I. Heuser,
B. Müller-Oerlinghausen, B. Hawellek, W. Maier, M.L. Rao,
W.Felber, U. Lewitzka, M. Oehler, A. Brooks, F. Hohagen, E.Lauterbach
3rd International Symposium
Research Net Depression
Diagnoses: Axis I: Clinical Interview according to DSM-IV (MINI)
Axis II: Clinical Interview (SCID II)
Suicidality:Suicide Intent Scale (SIS) (Beck 1974)
Medical Damage Scale (MDS) (Beck 1975)
Risk Rescue Scale (RRS) (Weisman 1972)
Scale for Suicidal Ideation (SSI) (Beck 1974)
Hopelessness Scale (BHS) (Beck 1974)
Typology of Parasuicide (Felber 1998)
Depression:Observer's rating: HAM-D21 (Hamilton)
Self rating: BDI (Beck Depression Scale)
Anxiety:Trait: STAI (Spielberger)
State: HAM-A (Hamilton)
Aggressivity/Impulsivity:FAF (modified Buss Durkee)
BIRS (Barrat Impulsivity Rating Scale)
IRS (Lecrubier Impulsivity Rating Scale)
Personality traits:TCI (Cloninger)
assessed and evaluated by the different centres:
CSF (and plasma) HPA system: MPI-P
CRH, ACTH, Cortisol Munich
AVP, Oxytocin Excitatory and inhibitory amino acids
5-HT system: 5-HIAA, 5-HT
NA system: MHPG
DA system: HVA
Blood (and platelets) 5-HT2A receptors (platelets) LMU Munich
MAO-B (platelets) Berlin
tryptophan, other amino acids (plasma) Berlin
5-HT concentration (platelets) Bonn
cholesterol, essential fatty acids (plasma) MPI-P Munich
Saliva cortisol Dresden
Molecular- and see subproject 5 LMU and pharmacogenetics Bonn
(1) The majority of patients so far included were inpatients of the six centres participating in subproject 1.5 (neurobiology of suicidal behaviour).
(2) Additional patients could be recruited as in- and outpatients of the lithium-intervention study (subproject 1.2).
We intend to match suicidal and non-suicidal patients for diagnoses, age, sex and seasonality. For matched pairs comparisons, a high sample size will be necessary
Minimum sample size of 42 for both patient groups.
Recruitment of patients and controls
(recruitment period: January 1, 2001 —April 30, 2003)
Molecular Peripheral CSF
Recruited 213 103 (67 SA) 44
with critical reference to
methodological and conceptual deficits by the research groups of
et al. 1999, 2001a and 2002a) and
et al. 2002).
The center LMU (
et al. 2000 a) found a higher frequency of the short
allele of the 5-HT promoter region (
) in suicide victims. The same
group could not replicate a
polymorphism of the 5-HT
victims and patients with suicidal ideation (
et al. 2000 b).
The research group of
and the group of the
surprisingly showed that no statistical correlation exists between
in platelets and the
polymorphism and the 17bp variable
number of tandem repeat
(Kaiser et al. 2002).
et al. (2001 a) found
lower CRH concentrations in the CSF of suicide
as compared to psychiatric controls. A preliminary study showed
differences in CSF AVP
between depressed suicide
and neurological controls (
concentrations in suicide
have been reported in
clinical studies, however, cholesterol-lowering therapies do not increase the risk
of suicide (
et al. 2001 b, 2002c).
Brunner J et al. (2001) Decreased corticotropin releasing hormone (CRH)
concentrations in the cerebrospinal fluid of eucortisolemic suicide attempters.
Journal of Psychiatric Research 35: 1-9
Brunner et al. (2002) Vasopressin in CSF and serum in depressed suicide attempters: correlations with monoamine metabolites and dexamethasone CRH test.
European Neuropsychopharmacology 12: 489-494
Brunner et al. (2003) Proteomics analysis of the CSF in unmedicated patients
with major depressive disorder reveals alterations in suicide attempters
The recruitment of the patients could not be finished within the first three years of funding between January 2000 to December 2002 because the approval of the applications to the local ethics committees resulted in a delay of one year, so that the recruitment of the neurobiological parameters started later than planned: at the beginning of 2001 instead of 2000.
Expected closing of the recruitment of patients according to the analysis of the matching process: December 2003.
2004: Data analysis, evaluation and publishing of the data.
Subproject 1.2: Lithium-intervention study
Subproject 5: Molecular- and pharmacogenetics