Suicide is a major cause of death in the United States and throughout the developed world. About 35,000 Americans took their own lives in the last year, according to National Institute of Mental Health estimates. Adolescents are among the most frequent suicide attempters, and even though less than 10 percent succeed, many who take their lives make repeated attempts. Suicide is a leading cause of adolescent death, especially among males.
As described in the Foundation’s spring 2013 issue of The Quarterly (pages 7 and 10), doctors have a well-developed list of risk factors that may help those close to troubled people recognize warning signs prior to a suicide attempt. At the same time, researchers have been looking for markers of risk that could be spotted objectively, in brain scanning imagery.
The search for biomarkers of elevated suicide risk in adolescents is one objective of research conducted by Lisa A. Pan, M.D., a 2012 NARSAD Young Investigator Grantee; David A. Brent, M.D., (2006 Ruane Prize and 2001 Distinguished Investigator Grant); and Mary L. Phillips, M.D., (2005 NARSAD Independent Investigator Grant). In a paper Dr. Pan and Dr. Phillips published December 9th in the journal Neuropsychopharmacology, their progress toward finding such objective biomarkers is described.
Drs. Pan and Phillips note that at least three patterns have been detected via functional magnetic resonance imaging (fMRI) brain scans that correlate with suicidal behavior in adults. (These brain scans were compared with those of depressed people who were not suicidal, as well as healthy control subjects). But no such body of data exists for adolescents with suicidal tendencies. “This is an important oversight because suicide is a leading cause of death in adolescents, and because the developing brain may provide a window into risk factors that could pave the way to early interventions,” Drs. Pan and Phillips write.
In their fMRI studies of adolescents with a history of depression and suicide attempt―who were asked to view angry faces―Drs. Pan, Phillips and colleagues reported abnormal functioning of brain areas that process attention and “salience” (i.e., the perceived importance of a stimulus). These abnormalities were seen specifically when suicidal adolescents were having an emotional response to someone or some situation. In the absence of emotional stimuli, these functions were normal in the brain scans. The team believes these signals could be markers of young people who have already made suicide attempts. They will now apply the same technology to search for scan patterns that might indicate high risk for future attempts in adolescents.