Periventricular white matter hyperintensities as predictors of suicide attempts in bipolar disorders and unipolar depression

Maurizio Pompili, Marco Innamorati, J. John Mann, Maria A. Oquendo, David Lester, Antonio Del Casale, Gianluca Serafini, Silvia Rigucci, Andrea Romano, Antonino Tamburello, Giovanni Manfredi, Eleonora De Pisa, Stefan Ehrlich, Giancarlo Giupponi, Mario Amore, Roberto Tatarelli, Paolo Girardi

Research output: Contribution to journalArticlepeer-review


The aim of this study was to evaluate whether deep white matter hyperintensities (DWMH) and periventricular white matter hyperintensities (PVH) are associated with suicidal behavior in patients with major affective disorders. Subjects were 99 consecutively admitted inpatients (42 men; 57 women; mean age: 46.5 years [SD = 15.2; Min./Max. = 19/79]) with a diagnosis of major affective disorder (bipolar disorder type I, bipolar disorder type-II and unipolar major depressive disorder). 44.4% of the participants had made at least one previous suicide attempt. T2-weighted brain magnetic resonance images were rated for the presence and extension of WMH using the modified Fazekas scale. Patients were interviewed for clinical data on average 5 days after admission. Bivariate analyses, corrected for multiple-testing, and logistic regression analysis were used to test the association between suicide attempts and clinical variables. Attempters and nonattempters differed only in the presence of PVH-the former were more likely to have PVH. The logistic regression indicated that the presence of PVH was robustly associated with suicidal behaviors after controlling for age (OR: 8.08). In conclusion, neuroimaging measures may be markers of risk for suicidal attempts in patients with major affective disorders.

Original languageEnglish
Pages (from-to)1501-1507
Number of pages7
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Issue number6
Publication statusPublished - Aug 1 2008


  • Bipolar disorder
  • Major affective disorders
  • Major depressive disorder
  • Suicide
  • White matter hyperintensities

ASJC Scopus subject areas

  • Biological Psychiatry
  • Pharmacology


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