Pain, Reward, Attention and Neurocircuitry: Biomarkers of Suicidality

The ultimate aim of this study is to identify a biomarker of suicide risk in MDD by measuring the "hedonic spectrum" (pain and reward responsivity), attention and its associated brain structures using brain scans (fMRI and DTI), as well as the stability of markers over time.

Study Overview

• Status: Completed
• Conditions: Suicidal Ideation; Suicide; Major Depressive Disorder
• Intervention / Treatment: Other: No intervention

Detailed Description

The issue of suicide has continued to puzzle researchers in the field of psychiatry. Edwin Shneidman, a prominent researcher on suicide emphasized "the most evident fact about suicidology and suicidal events is that they are multidimensional…containing concomitant biological, sociological, and psychological (interpersonal and intrapsychic)…elements". Yet, no study to date has attempted to integrate these dimensions when evaluating suicide risk. Considering the presence of a psychiatric illness is a primary predictor of suicide, it is important to develop a unified understanding of risk factors that integrate current clinical and neurobiological findings in this population.

Our aim is to: (1) identify an integrated biomarker model to predict risk of suicide attempt in patients with Major Depressive Disorder (MDD) with and without a history of suicide attempt, using neuroimaging, neurocognitive testing and behavioural tasks, and (2) test the stability of this model using a prospective 1 year design.

• Study Type: Observational
• Enrollment (Actual): 97

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M5B1M8
      • Sakina Rizvi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

Subjects will recruited from Mental Health Clinics at St. Michael's Hospital from Mood Disorders Clinics, University Health Networks (UHN) hospitals, and self-referrals from advertisements in Mental Health Department, and on social media.

Description

Inclusion Criteria:

1. DSM-5 criteria for Major Depressive Episode within a MDD, confirmed through MINI diagnosis104
2. Ages between 18 and 70 years
3. Hamilton Depression Rating Scale - 17 item (HAMD-17) >= 14
4. Capable of giving informed consent
5. Groups 1 and 2 participants only: HAMD-17 item 3 (suicide) >= 2
6. Group 2 participants only: positive history of a suicide attempt within the last six months
7. Group 3 participants only: positive history of a lifetime suicide attempt

Exclusion Criteria:

1. Pregnancy/lactation
2. Medical condition requiring immediate investigation or treatment
3. Recent (< 6 months)/current history of drug abuse/dependence (other than caffeine, or nicotine)
4. Lifetime history of psychosis, Bipolar I or Bipolar II; other Axis I comorbidities are allowable
5. Individuals who are taking a daily sedative hypnotic, atypical antipsychotic or stimulant must be on a stable dose for at least 4 weeks prior to the neuroimaging scan. The dose must not be taken after 10:00pm the evening prior to the scan. Those receiving a benzodiazepine or an atypical antipsychotic on an "as needed" basis (taken, but not every day) will be washed out of their benzodiazepine/atypical antipsychotic for two weeks prior to neuroimaging. Those receive stimulants on an "as needed" basis will be washed out for 1-3 days prior to neuroimaging, depending on the stimulant half-life.
6. Participation in experimental treatment trials for the study duration.

Study Plan

How is the study designed?

Number of groups / cohorts

4

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
MDD with SI and No Attempt; Subjects will have MDD with current MDE, current suicidal ideation and no lifetime suicide attempts	Other: No intervention
MDD with SI and Recent Attempt; Subjects with have MDD with current MDE, current suicidal ideation and a suicide attempt within the past 6 months	Other: No intervention
MDD with no SI and Lifetime Attempt; Subjects with MDD and current MDE but no current suicidal ideation and a lifetime suicide attempt.	Other: No intervention
Healthy Controls; Subjects will have no personal or family psychiatric history and no suicide attempts.	Other: No intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Biomarkers for Suicide Risk	Potential biomarkers for suicide risk including brain scans, genomic or proteomic makers,	12 months

Collaborators and Investigators

• Sponsor: Unity Health Toronto
• Investigators: Principal Investigator: Sakina Rizvi, PhD, Unity Health Toronto

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2017
• Primary Completion (Actual): December 9, 2024
• Study Completion (Actual): January 30, 2025

Study Registration Dates

• First Submitted: June 20, 2016
• First Submitted That Met QC Criteria: June 20, 2016
• First Posted (Estimated): June 23, 2016

Study Record Updates

• Last Update Posted (Actual): February 27, 2026
• Last Update Submitted That Met QC Criteria: February 24, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Behavioral Symptoms; Self-Injurious Behavior; Mood Disorders; Depressive Disorder; Behavior; Suicide; Suicidal Ideation; Depressive Disorder, Major
• Other Study ID Numbers: SBIO-01