Citation

Ballard ED, Ionescu DF, van de Voort JL, Slonena EE, Franco-Chaves JA, Zarate CA, Grillon C. J. Affect. Disord. 2014; 162: 34-38.

Affiliation

Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.jad.2014.03.027

PMID

24767002

Abstract

BACKGROUND: Suicide is a common reason for psychiatric emergency and morbidity, with few effective treatments. Anxiety symptoms have emerged as potential modifiable risk factors in the time before a suicide attempt, but few studies have been conducted using laboratory measures of fear and anxiety. We operationally defined fear and anxiety as increased startle reactivity during anticipation of predictable (fear-potentiated startle) and unpredictable (anxiety-potentiated startle) shock. We hypothesized that a lifetime history of suicide attempt (as compared to history of no suicide attempt) would be associated with increased fear-potentiated startle.

METHODS: A post-hoc analysis of fear- and anxiety-potentiated startle was conducted in 28 medication-free patients with Major Depressive Disorder (MDD) divided according to suicide attempt history.

RESULTS: The magnitude of fear-potentiated startle was increased in depressed patients with lifetime suicide attempts compared to those without a lifetime history of suicide attempt (F(1,26)=5.629, p=.025). There was no difference in anxiety-potentiated startle by suicide attempt history. LIMITATIONS: This is a post-hoc analysis of previously analyzed patient data from a study of depressed inpatients. Further replication of the finding with a larger patient sample is indicated.

CONCLUSIONS: Increased fear-potentiated startle in suicide attempters suggests the role of amygdala in depressed patients with a suicide attempt history.

FINDINGS highlight the importance of anxiety symptoms in the treatment of patients at increased suicide risk.

Language: en