Identifying the Neural Basis of Capability for Suicide

Since capability for suicide involves overriding potential pain, and the opioid system plays a strong role in controlling pain perception, it follows that capability for suicide may be impacted by the opioid system. The goal of the proposed research is to identify the neural network underlying capability for suicide in order to determine if it can be a target for identifying high-risk individuals and for intervention.

Study Overview

• Status: Suspended
• Conditions: Suicidal Ideation; Suicide; Major Depressive Disorder; Psychiatric Illness
• Intervention / Treatment: Procedure: fMRI

Detailed Description

Little evidence exists distinguishing individuals with suicidal ideation (SI) from those at risk for suicidal behaviour, illustrating the need for more comprehensive biomarkers for clinicians to guide their treatment approach and for new treatment avenues. Current theories of suicide have suggested the importance of an individual's capability for suicide in predicting suicide attempt or death. Building on this, Yovell and colleagues (2016) provided important preliminary data that the opioid system affects suicide risk, but the neural mechanisms and their relationship to capability for suicide are unclear. The goal of the proposed research is to identify the neural network underlying capability for suicide using functional magnetic resonance imaging (fMRI) in order to determine if it can be a target for identifying high-risk individuals and for intervention.

• Study Type: Observational
• Enrollment (Estimated): 90

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M5B 0C1
      • St. Michael's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 55 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 and self-referrals from advertisements in Mental Health Department.

Description

Inclusion criteria for patients:

• Age between 18-70
• Capability of giving informed consent
• Not currently pregnant or lactating (due to potential confounding of brain activity as a result of differing hormone levels)

Exclusion criteria for patients:

• Lifetime history of any substance abuse, psychosis
• Current use of any opioid acting drugs
• Current use of any prescription pain medication
• Use of over the counter pain medications within 15 hours of brain scan
• For daily users of a benzodiazepine, stimulant or atypical antipsychotic, dose within 12 hours of brain scan
• For as needed users of a benzodiazepine, stimulant or atypical antipsychotic, dose within 2 weeks of brain scan. This is because non-daily use will have more unpredictable effects on brain imaging results than those who are using these medications on a regular basis. The 2 weeks will ensure the drug is not in the system.
• Medical condition requiring immediate investigation or treatment
• Participation in experimental treatment trials for the study duration.

Healthy control inclusion criteria: Ages between 18 and 70 years, capable of giving informed consent, not pregnant or lactating, no lifetime history of Axis I/II disorders, no history of antidepressant or mood stabilizer use, no treatment for acute or ongoing medical condition, no use of any over the counter pain medication for at least 15 hours prior to the brain scan.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Healthy Controls; Subjects will have no personal or family psychiatric history and no suicide attempts.	Procedure: fMRI; An fMRI scan will be conducted to collect neuroimaging data. The scanning session will consist of a structural MRI, followed by resting state and task-based functional MRI protocol.
Patients with SI; Subjects will have suicidal ideation (Hamilton Depression Rating Scale suicide item >=2).	Procedure: fMRI; An fMRI scan will be conducted to collect neuroimaging data. The scanning session will consist of a structural MRI, followed by resting state and task-based functional MRI protocol.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neural network underlying acquired capability for suicide	Measure the correlation between acquired capability for suicide and brain activity during a pressure pain task using fMRI in patients	2 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation between pain task performance and acquired capability for suicide	Assess the association between pain task ratings and acquired capability for suicide in patients	2 weeks

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, 2023
• Primary Completion (Actual): April 1, 2025
• Study Completion (Estimated): September 1, 2028

Study Registration Dates

• First Submitted: October 23, 2017
• First Submitted That Met QC Criteria: October 26, 2017
• First Posted (Actual): October 31, 2017

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

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No