Hopelessness, Dissociative Symptoms, and Suicide Risk in Major Depressive Disorder: Clinical and Biological Correlates

Abstract

Background: Major depressive disorder (MDD) has different clinical presentations and is associated with neurobiological alterations. Hopelessness, anhedonia, and dissociation represent some of the most pervasive psychopathological symptoms that often lead to suicidal thoughts, attempts, and actions. To further research on the concept of depression endophenotypes, this study aimed to assess the possible relationships between hopelessness and other clinical and biological correlates (i.e., striatal dopaminergic dysfunction) in depressed patients. Methods: We recruited 51 subjects with MDD. All subjects underwent 123I-FP-CIT SPECT to assess striatal dopamine transporter (DAT) availability and a psychometric evaluation using the psychometric scale to assess depressive, anxious, dissociative, and hopelessness symptoms aside from suicidal ideation. Result: An inverse correlation between the hopelessness score and dopamine transporter availability in all basal ganglia was bilaterally found. (Right Putamen, r = −0.445, p < 0.01; Left Putamen, r = −0.454, p < 0.01; Right Caudate, r = −0.398, p < 0.01; Left Caudate, r = −0.467, p < 0.01) Moreover, a positive correlation was also found between hopelessness and dissociative symptoms. Conclusions: These results provide important evidence on the neurobiological and clinical correlates of different psychopathological symptoms of depression with potential implications in terms of devising more effective treatment programs.

Suicidality Associated With Deep Brain Stimulation in Extrapyramidal Diseases: A Critical Review and Hypotheses on Neuroanatomical and Neuroimmune Mechanisms

“…In fact, dysregulated activation of dopamine signaling, particularly in the dorsal striatum (the main target of SNc dopaminergic projections), has been linked to suicide (Fitzgerald et al, 2017). Consistent with this report, a recent study has demonstrated a correlation between reduced dopamine transporter availability and increased hopelessness scores in all bilateral striatal areas of subjects with major depressive disorders (MDD; Pettorruso et al, 2020). Last but not least, it is also worth noting that a rapid post-DBS reduction in dopamine therapy might cause a general hypodopaminergic state in the brain and the unmasking of depression and SI in PD patients (Berardelli et al, 2019).…”

Religious Coping, Hopelessness, and Suicide Ideation in Subjects with First-Episode Major Depression: An Exploratory Study in the Real World Clinical Practice

“…Knowing the risk factors for suicide in MDD and how to get help can save lives [5,6]. Among these factors, hopelessness is often associated with an increase in suicide risk [7,8]. Hopelessness is a cognitive style characterized by pessimistic expectations for the future, absence of motivation, and the attribution of erroneous implications to own experiences [7,9].…”

“…Among these factors, hopelessness is often associated with an increase in suicide risk [7,8]. Hopelessness is a cognitive style characterized by pessimistic expectations for the future, absence of motivation, and the attribution of erroneous implications to own experiences [7,9]. It has also been suggested that hopelessness may act as a mediator between depressive symptoms and suicidality [10].…”

Monocyte chemoattractant protein-1 levels are associated with major depressive disorder

“…This is happened due to the lack of efficacy or intolerable side effects of antidepressant molecules especially for those who have underlying immune deregulation (Rush et al, 2006; Trivedi et al, 2006). The high rate of treatment resistance may be responsible for the rising suicidal tendency of MDD patients and the unbearable economic burden to society (Pettorruso et al, 2020). Taken all these together, the present study proposed some new therapeutic approaches to improve the quality of life or even cure MDD patients.…”