Functional Imaging of Psychic Pain

Neuro Anatomic Basis of Psychic Pain in Depression and Suicidal Behaviour

Suicidal behaviour (SB) represents a major public health problem, costing life in more that one million people every year worldwide. Even if SB is considered as a consequence of social adversity and depression, these stress factors are often necessary but not sufficient to explain the occurrence of a suicidal act. A preliminary study suggests that an increased perception of psychic pain during a major depressive disorder increases the risk of suicide behaviour. The investigators aimed to investigate the relationship between social exclusion (a classic trigger of psychic pain) and SB and improve our knowledge about the physiopathology of this domain.

Study Overview

• Status: Terminated
• Conditions: Suicide, Attempted; Mood Disorder
• Intervention / Treatment: Procedure: blood sample; Behavioral: Assessment of personality traits; Behavioral: Assessment of suicidal act; Behavioral: Assessment of depression; Procedure: Cyber ball game; Procedure: Iowa Gambling Task; Procedure: Microcomputer

Detailed Description

Suicide behaviour (SB) represents a major public health problem. In order to improve prevention strategies, a better understanding of the physiopathology of SB is needed. According to a "stress vulnerability" model, people who make a suicide attempt when they are subject to a stress factor (environmental stress, interpersonal difficulties, depression, tobacco, substance abuse...) are those who have a specific vulnerability. Vulnerability factors to SB may be considered in clinical terms (propensity to hopelessness, aggressive impulsivity traits), neurobiological terms (serotoninergic system disorder, especially in the ventral prefrontal cortex-vPFC) and cognitive terms (decision making, cognitive functions mediated by the vPFC and the serotoninergic system). Finally, genetic factors seem also involved in suicide vulnerability. The investigators have conducted a preliminary study which suggests that increased perception of psychic pain during a major depressive disorder increases suicidal ideation and suicidal act. Study about anatomic basis of psychic pain and its triggers represents a relevant theme to understand the suicidal process. Among the classical factors triggering psychic pain and suicidal act, events of social exclusion appears to be crucial. Finally, many data suggests the close relationship between physic and psychic pain.

• Study Type: Interventional
• Enrollment (Actual): 123
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Montpellier, France, 34000
    • MontpellierUniversity Hopital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Non specific criteria, for all the participants:

• Woman- 18-50 years old
• Non menopausal
• Right-handed
• Caucasian from western Europe (exception of Basque and Sardinian), for genetic purposes
• Subject who signed informed consent
• Able to understand the nature, the aim, and the methodology of the study and agree to cooperate during clinical and radiological evaluation

Specific criteria:For depressed suicide attempters :

• DSM IV criteria for major depressive disorder
• Personal history of suicide attempt
• No psychotropic treatment currently

For depressed affective controls :

• DSM IV criteria for major depressive disorder
• No personal history of suicide attempt
• No psychotropic treatment currently

For non depressed suicide attempters :

• Personal history of unipolar or bipolar mood disorder, according to DSM IV criteria
• Normothymic currently (HAMD<7)
• Personal history of suicide attempt
• Minimum treatment Healthy controls :
• No personal history of axis I psychiatric disorders according to the MINI and the DSM IV criteria

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Control	Procedure: blood sample; blood sample; Behavioral: Assessment of personality traits; suicide behaviour , psychic pain, social exclusion, decision making...; Other Names: impulsivity; anger; anxiety; emotional lability; self-administered questionnaires; Behavioral: Assessment of suicidal act; suicide behaviour , psychic pain, social exclusion, decision making...; Other Names: SIS; RRRS; Behavioral: Assessment of depression; suicide behaviour , psychic pain, social exclusion, decision making...; Other Names: BDI; HAMD-21; Procedure: Cyber ball game; functional neuroimaging; Other Names: fIRM; Procedure: Iowa Gambling Task; functional neuroimaging; Procedure: Microcomputer; functional neuroimaging; Other Names: palm
Experimental: Depressive attempters	Procedure: blood sample; blood sample; Behavioral: Assessment of personality traits; suicide behaviour , psychic pain, social exclusion, decision making...; Other Names: impulsivity; anger; anxiety; emotional lability; self-administered questionnaires; Behavioral: Assessment of suicidal act; suicide behaviour , psychic pain, social exclusion, decision making...; Other Names: SIS; RRRS; Behavioral: Assessment of depression; suicide behaviour , psychic pain, social exclusion, decision making...; Other Names: BDI; HAMD-21; Procedure: Cyber ball game; functional neuroimaging; Other Names: fIRM; Procedure: Iowa Gambling Task; functional neuroimaging; Procedure: Microcomputer; functional neuroimaging; Other Names: palm

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cerebral regions associated with psychic pain during a major depressive disorder	Magnetic Resonance Imaging to visualize cerebral regions associated with psychic pain during a major depressive disorder	One day
Cerebral regions associated with perception of social exclusion	Magnetic Resonance Imaging to visualize the cerebral regions associated with perception of social exclusion	One day

Collaborators and Investigators

• Sponsor: University Hospital, Montpellier
• Collaborators: University Hospital, Geneva; Institut National de la Santé Et de la Recherche Médicale, France
• Investigators: Principal Investigator: Philippe PC Courtet, Professor(MD-PhD), University Hospital, Montpellier

Study record dates

Study Major Dates

• Study Start: May 1, 2010
• Primary Completion (Actual): August 1, 2014
• Study Completion (Actual): December 1, 2014

Study Registration Dates

• First Submitted: November 10, 2011
• First Submitted That Met QC Criteria: December 13, 2011
• First Posted (Estimate): December 15, 2011

Study Record Updates

• Last Update Posted (Estimate): December 4, 2014
• Last Update Submitted That Met QC Criteria: December 3, 2014
• Last Verified: December 1, 2014

More Information

Terms related to this study

• Keywords: Genetic; Mood disorders; Suicide, attempted; Magnetic Resonance Imaging, Functional; Psychic pain; Social exclusion; Physic pain
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Self-Injurious Behavior; Suicide; Suicide, Attempted; Mood Disorders
• Other Study ID Numbers: UF 8555