Functional Imaging of Psychic Pain

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Neuro Anatomic Basis of Psychic Pain in Depression and Suicidal Behaviour

Conditions
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Suicide, Attempted, Mood Disorder

Intervention / Treatment
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* Behavioral: Assessment of personality traits
* Behavioral: Assessment of suicidal act
* Behavioral: Assessment of depression
* Procedure: Cyber ball game
* Procedure: Iowa Gambling Task
* Procedure: Microcomputer
* Procedure: blood sample


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Control<br> | Behavioral: Assessment of personality traits<br>* suicide behaviour , psychic pain, social exclusion, decision making...<br>* Other names: self-administered questionnaires;Behavioral: Assessment of suicidal act<br>* suicide behaviour , psychic pain, social exclusion, decision making...<br>* Other names: RRRS;Behavioral: Assessment of depression<br>* suicide behaviour , psychic pain, social exclusion, decision making...<br>* Other names: HAMD-21;Procedure: Cyber ball game<br>* functional neuroimaging<br>* Other names: fIRM;Procedure: Iowa Gambling Task<br>* functional neuroimaging<br>Procedure: Microcomputer<br>* functional neuroimaging<br>* Other names: palm;Procedure: blood sample<br>* blood sample<br>|
| Experimental: Depressive attempters<br> | Behavioral: Assessment of personality traits<br>* suicide behaviour , psychic pain, social exclusion, decision making...<br>* Other names: self-administered questionnaires;Behavioral: Assessment of suicidal act<br>* suicide behaviour , psychic pain, social exclusion, decision making...<br>* Other names: RRRS;Behavioral: Assessment of depression<br>* suicide behaviour , psychic pain, social exclusion, decision making...<br>* Other names: HAMD-21;Procedure: Cyber ball game<br>* functional neuroimaging<br>* Other names: fIRM;Procedure: Iowa Gambling Task<br>* functional neuroimaging<br>Procedure: Microcomputer<br>* functional neuroimaging<br>* Other names: palm;Procedure: blood sample<br>* blood sample<br>|

What is the study measuring?
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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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Psychic pain, Social exclusion, Mood disorders, Suicide, attempted, Magnetic Resonance Imaging, Functional, Genetic, Physic pain