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| 2. |
- Bah Rösman, Jessica, 1975, et al.
(författare)
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Serotonin transporter gene polymorphisms: Effect on serotonin transporter availability in the brain of suicide attempters
- 2008
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Ingår i: Psychiatry Research: Neuroimaging. - : Elsevier BV. - 0925-4927 .- 0165-1781. ; 162:3, s. 221-229
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Tidskriftsartikel (refereegranskat)abstract
- The efficacy of serotonin reuptake inhibitors in depression and anxiety disorders suggests the gene coding for the serotonin transporter (5-HTT), SLC6A4, as a candidate of importance for these conditions. Positive findings regarding associations between polymorphisms in SLC6A4 have been reported, indicating that these polymorphisms may influence anxiety-related personality traits, as well as the risk of developing depression and suicidality. Serotonin 5-HTT availability was assessed with single photon emission computed tomography (SPECT), using I-123-beta-CIT as ligand, in a population of unmedicated male suicide attempters (n=9) and in matched controls (n=9). Two polymorphisms in SLC6A4 were assessed, including the 5-HTTLPR located in the promoter region and a variable number of tandem repeats (VNTR) polymorphism in intron 2 (STin2). In suicide attempters, but not in controls, low 5-HTT availability was associated with the S allele of 5-HTTLPR and with the 12 repeat allele of STin2. Data suggest that polymorphisms in SLC6A4 may influence the expression of the brain serotonin transporter in suicide attempters.
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| 4. |
- Brundin, Lena, et al.
(författare)
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Cocaine and amphetamine regulated transcript (CART) in suicide attempters.
- 2008
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Ingår i: Psychiatry Research. - : Elsevier BV. - 1872-7123 .- 0165-1781. ; 158:2, s. 117-122
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Tidskriftsartikel (refereegranskat)abstract
- Cocaine and amphetamine regulated transcript (CART) is a neuropeptide expressed in brain regions thought to regulate anxiety levels, depression, addiction and energy homeostasis. Individuals with a CART mutation display increased anxiety and depression. Severe anxiety is a core phenomenon of suicidality. We therefore studied levels of CART in the cerebrospinal fluid (CSF) of 98 patients with different psychiatric diagnoses, shortly after a suicide attempt. We also investigated the relationship between CSF-CART and relevant psychiatric symptoms. CART levels were determined using a radioimmunoassay and the psychiatric symptoms rated in structured interviews using the Comprehensive Psychopathological Rating Scale (CPRS) and the Karolinska Scales of Personality (KSP). No differences in CSF-CART were found between the diagnostic groups or controls. However, lower CART levels were associated with a higher degree of concentration difficulties. No significant association was found between CART levels and other psychiatric symptoms. CSF-CART correlated significantly with CSF-levels of orexin, but not with corticotrophin releasing factor (CRF). Further studies on the role of CART in psychiatric diseases where concentration difficulties are prominent, such as attention deficit disorder, are warranted.
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| 5. |
- Brundin, Lena, et al.
(författare)
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Increased orexin levels in the cerebrospinal fluid the first year after a suicide attempt.
- 2009
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 1573-2517 .- 0165-0327. ; Jun 2, s. 179-182
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The orexins (hypocretins) and cocaine and amphetamine regulated transcript (CART) are hypothalamic peptides involved in the regulation of sleep and appetite. We have previously shown that levels of both orexin-A and CART in the cerebrospinal fluid (CSF) are related to specific psychiatric symptoms. METHODS: Ten patients took part in lumbar punctures and psychiatric evaluations in conjunction to a suicide attempt and after 6 and 12 months. We measured CSF-orexin and CART using radioimmunoassays. RESULTS: Mean CSF-orexin was significantly higher at the first and second follow-up than at the suicide attempt. In contrast, mean CSF-CART did not differ over time. Total SUAS scores, as well as ratings of CPRS item 66 (global illness) were significantly lower at follow-up. At one year, there was a significant negative correlation between the change in CSF-orexin and the change in total SUAS score. LIMITATIONS: The number of patients who participated was relatively small. CONCLUSIONS: Our results support the hypothesis that orexin is involved in psychiatric symptomatology.
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| 6. |
- Brundin, Lena, et al.
(författare)
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Orexin and psychiatric symptoms in suicide attempters.
- 2007
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 1573-2517 .- 0165-0327. ; 100:1-3, s. 259-263
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The orexins (hypocretins) are recently discovered hypothalamic peptides that are involved in the regulation of sleep, appetite and state of arousal. In the present study, we investigated the relationship between cerebrospinal fluid (CSF) orexin and specific psychiatric symptoms in suicidal patients. METHODS: A total of 101 patients were enrolled in the study shortly after a suicide attempt. All patients underwent a lumbar puncture after a wash-out period during which they did not receive any antipsychotic or antidepressive medication. Structured interviews were performed using the Comprehensive Psychopathological Rating Scale (CPRS). CSF-orexin-A was measured and correlated with ratings of psychiatric symptoms. RESULTS: There were significant and negative correlations between CSF-orexin and the symptoms lassitude (difficulty to initiate activities) and slowness of movement, as well as the ratings of global illness (p<0.005 for all three items, Spearman's rho). LIMITATIONS: Correlation analysis is an indirect method of investigation and does not demonstrate causal relationships. CONCLUSION: Low CSF-orexin levels are related to pronounced symptoms of inertia and reduced motor activity in suicidal patients. Interestingly, the lower the orexin levels, the higher were ratings of overall illness, as observed by a specialist in psychiatry. Our results suggest that reduced orexin levels are involved in the etiology of specific psychiatric symptoms.
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| 7. |
- Brundin, Lena, et al.
(författare)
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Reduced orexin levels in the cerebrospinal fluid of suicidal patients with major depressive disorder.
- 2007
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Ingår i: European Neuropsychopharmacology. - : Elsevier BV. - 1873-7862 .- 0924-977X. ; 17:Mar 6, s. 573-579
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Tidskriftsartikel (refereegranskat)abstract
- Orexins are neuropeptides selectively expressed in a small number of neurons in the lateral–posterior hypothalamus. We measured orexin-A in the cerebrospinal fluid (CSF) of 66 patients with major depressive disorder (MDD), dysthymia and adjustment disorder after a suicide attempt. Blood samples confirmed that the patients were free from antidepressive and neuroleptic medication at the time of the lumbar punctures. CSF levels of orexin-A were significantly lower in patients with MDD than in patients with adjustment disorder and dysthymia. Orexin correlated significantly with CSF levels of somatostatin, delta sleep inducing peptide-like immunoreactivity (DSIP-LI) and corticotrophin releasing factor (CRF), but not with leptin or vasopressin. Plasma levels of thyroid-stimulating hormone (TSH) were not reduced in MDD patients, and did not correlate with CSF-orexin. Our results suggest that suicidal patients with MDD have distinct neurobiological features, involving compromised levels of hypothalamic peptides regulating the state of arousal.
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| 8. |
- Henningsson, Susanne, 1977, et al.
(författare)
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Genetic Variation in Brain-Derived Neurotrophic Factor Is Associated with Serotonin Transporter but Not Serotonin-1A Receptor Availability in Men
- 2009
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Ingår i: Biological Psychiatry. - : Elsevier BV. - 0006-3223 .- 1873-2402. ; 66:5, s. 477-485
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Tidskriftsartikel (refereegranskat)abstract
- Background: The serotonergic system, including the serotonin transporter (5-HTT), which is the target of many antidepressants, seems to be influenced by brain-derived neurotrophic factor (BDNF). Methods: Positron emission tomography (PET) was used to address, in 25 and 53 healthy volunteers, respectively, the possible association between six polymorphisms in the gene encoding BDNF and the availability of two proteins expressed by serotonergic neurons: the 5-HTT, measured with the radioligand [C-11]MADAM, and the serotonin-1A (5-HT1A) receptor, measured with [C-11]WAY-100635. Results: Several single nucleotide polymorphisms were associated with [C-11]MADAM binding potential (BP) in most brain regions, male carriers of the valine/valine genotype of the Val66Met polymorphism displaying higher availability. Effect sizes ranged from a 50% to a threefold increase. In contrast, there was no association for [C-11]WAY-100635 BP. The observation that BDNF polymorphisms were associated with 5-HTT availability could be partly replicated in an independent population comprising nine male suicide attempters and nine matched control subjects, in which transporter availability had been measured with single photon emission computed tomography with I-123-beta-CIT as ligand. Conclusions: Our results suggest that genetic variation in BDNF influences 5-HTT but not 5-HT1A receptor density in the human brain.
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| 9. |
- Holmstrand, Cecilia, et al.
(författare)
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Disentangling dysthymia from major depressive disorder in suicide attempters' suicidality, comorbidity and symptomatology.
- 2008
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 62:1, s. 25-31
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Tidskriftsartikel (refereegranskat)abstract
- Dysthymia and major depressive disorder (MDD) are both risk diagnoses for suicidal behaviour. The aim of the present study was to identify clinical differences between these disorders, with a special reference to dysthymia. We studied suicidal behaviour, comorbidity and psychiatric symptoms of inpatient suicide attempters with dysthymia and MDD. We used DSM III-R diagnostics, the Suicide Assessment Scale (SUAS) and the Comprehensive Psychopathological Rating Scale (CPRS), part of which is the Montgomery and Asberg Depression Rating Scale (MADRS). Suicide mortality, number of repeated suicide attempts, method of suicide attempt and comorbidity of Axis I did not differ between the groups. Dysthymia patients, however, suffered more than MDD patients from DSM-III-R Axis II diagnoses (above all cluster B). There was no significant difference in Axis III comorbidity. Total SUAS, CPRS and MADRS scores did not differ significantly between the groups. When studying separate SUAS and CPRS items in a multivariate analysis, the CPRS items "aches and pains", "increased speech flow", increased "agitation" and "less tendency to worrying over trifles" as well as young age remained independently associated with dysthymia. Dysthymia patients, who later committed suicide, more often reported increased "aches and pains" than those who did not commit suicide. In this small sample of suicide attempters, we conclude that dysthymia suicide attempters, more often than MDD patients, have a comorbidity with personality disorders, which combined with a picture of aches and pains, could be factors explaining their suicidality.
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| 10. |
- Holmstrand, C, et al.
(författare)
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Risk factors of future suicide in suicide attempters - A comparison between suicides and matched survivors
- 2006
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 60:2, s. 162-167
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to find risk factors for suicide by looking for clinical and care/treatment consumption differences between 15 hospitalized suicide attempters, who later committed suicide ("completers''), and 15 suicide attempters who did not ("non-completers''), matched according to sex, age and principal diagnosis. Completers had significantly more often attempted suicide after the index admission. After index, completers had received more psychiatric care and treatment than non-completers. Comorbidity was common in both groups of patients. Personality disorders according to the DSM III-R, axis II, Cluster B, however, tended to be more common in the completer group. Increased comorbidity over time could also be seen to a larger extent in completers. In spite of the matching of principal diagnosis, completers tended to have higher Montgomery -angstrom sberg Depression Rating Scale ratings than non-completers. They also had significantly higher Suicide Assessment Scale (SUAS) scores. From this study, it is apparent that suicide attempters at risk of future suicide have major and multiple psychiatric problems, which cause difficulties in the care and treatment.
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