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This Month in Archives of General Psychiatry
January 2003

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2003;60(1):11-12. doi:10.1001/archpsyc.60.1.11

Oquendo et al Article studiedthe relationship of seriousness of suicide attempts in terms of resultant medical damage in medication-free depressed suicide attempters' brain responses to serotonin with positron emission tomography imaging of 18F-flurodeoxyglucose. Depressed high-lethality suicide attempters had lower glucose turnover in ventral, medial and lateral prefrontal cortex compared with depressed, low-lethality attempters. Prefrontal hypofunction and impaired serotonergic responsivity correlated with lethality of the suicide attempt and appeared to mediate the effects of suicide intent and impulsivity. This method may aid in risk assessment for suicide.

Resistance to glucocorticoid negative feedback as assessed by dexamethasone has been shown by many investigators to occur in patients with major depression. However, dexamethasone evaluates only one type of glucocorticoid receptor, Type II or GR. Young et al Article evaluated the function of mineralocorticoid receptor (Type 1, MR) using spironolactone, an MR antagonist. Contrary to expectations, they found increased MR tone in subjects with major depression. This finding suggests an alteration in MR/GR ratio. Both MR and GR have been shown to regulate serotonin receptors and release. The implications for this finding with regard to serotonin receptors and depression are discussed.