White matter hyperintensities and their associations with suicidality in psychiatrically hospitalized children and adolescents.

OBJECTIVE: Increasingly, researchers and clinicians are recognizing that there may be biological markers associated with increased risk of suicide. The objective of this study was to compare white matter hyperintensities in psychiatrically hospitalized children and youth with and without a history of suicide attempt while controlling for other variables. METHOD: White matter hyperintensities of 153 child and adolescent psychiatry inpatients were rated on T2-weighted magnetic resonance imaging scans using a modified Coffey scale. DSM-IV diagnosis, history of suicide attempt, and control variables such as gender, age, comorbid medical illnesses, developmental disorder, substance abuse, severity of mental illness, head injury, and possible cerebral hypoxia were obtained from discharge medical records. RESULTS: Within the unipolar depression group (n = 48), white matter hyperintensities were significantly associated with a higher prevalence of past suicide attempts (Fisher exact test, p =.03). Logistic regression analysis confirmed this relationship, indicating that none of the control variables confounded our results and suggesting a specificity of 0.94. CONCLUSIONS: This is the first report of an increased prevalence of white matter hyperintensities in children and youth with unipolar depression and a history of suicide attempt. Replication and expansion of our preliminary findings could be of great clinical interest.

Subanalysis of the location of white matter hyperintensities and their association with suicidality in children and youth.

Our previous research with psychiatrically hospitalized children and youth indicates that white matter hyperintensities (WMH) on T2-weighted MRI images are associated with a history of suicide attempt. This subanalysis of the specific locations of the WMH suggests that youth with deep WMH in the parietal lobe but not in the frontal lobe have a significantly higher prevalence of reported past suicide attempt.