Brain circuits may reveal which young people are likely to commit suicide

A new Yale-led study of adolescents and young adults at high risk of taking their own lives — those suffering from bipolar disorder — implicates specific differences in the brains of those who attempt suicide and those who do not, researchers report Jan. 31 in the American Journal of Psychiatry.

In young adults with bipolar disease, decreased structural integrity of white matter in areas of the brain that regulate emotion is one marker which may help predict those most at risk of suicide attempts, researchers found.

“Suicide is a leading cause of death of adolescents and young adults, and we can’t move on this issue fast enough,” said Hilary Blumberg, the John and Hope Furth Professor of Psychiatric Neuroscience, professor in psychiatry, radiology, and biomedical imaging and in the Yale Child Study Center, and senior author of the study. “The identification of brain circuits involved in risk for suicide can lead to new ways to identify who is most at risk and hopefully, prevent suicides.”

About half of individuals with bipolar disorder, which is marked by extreme mood swings, attempt suicide in their lifetimes, and as many as one in five people with the disorder may die by suicide. In studies of adults who made suicide attempts, evidence implicates problems in the frontal-limbic system, where emotions and impulses arise, and the frontal cortex, which helps regulate emotions and impulses.

Blumberg and her colleagues studied adolescents and young adults. Since their frontal-limbic system is still under development, explain the researchers, studying them could provide windows onto how suicidal thoughts and behaviors arise. Blumberg and her team took specialized magnetic resonance imaging (MRI) scans of those who had attempted suicide and those who had not and found several telltale differences. Those who had attempted suicide had subtle decreases in the volume and activity in areas of the brain ciruitry that regulate emotion and impulses, and in the white matter, the wiring that provides connections between those brain areas.

“The findings suggest that the frontal cortex is not working as well as it should to regulate the circuitry,” Blumberg said. “That can lead to more extreme emotional pain, difficulties in generating alternate solutions to suicide and greater likelihood of acting on suicidal impulses.”

Blumberg said further research into brain circuitry developmental processes that lead to suicide can help identify individuals at risk of suicide. The findings may help clinicians develop new strategies to minimize risk factors and therapies designed to strengthen the vulnerable brain circuits.

Jennifer A.Y. Johnston is the lead author of the study. Funding for the research came from the National Institutes of Health, American Foundation for Suicide Prevention, International Bipolar Disorder Foundation, Brain and Behavior Research Foundation, Women’s Health Research at Yale, and The John and Hope Furth Endowment.

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