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000284362 041__ $$aEnglish
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000284362 1001_ $$0P:(DE-2719)9000336$$aWalter, Uwe$$b0$$eFirst author$$udzne
000284362 245__ $$aTranscranial sonography of the brainstem raphe: A rapid tool to assess the long-term risk of violent suicidal behavior in patients with major depression.
000284362 260__ $$aAmsterdam [u.a.]$$bElsevier Science$$c2026
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000284362 520__ $$aTo assess the relationship between ultrasonographic changes in midbrain structures and subsequent violent suicidal behavior.We conducted a retrospective analysis of a previously reported cohort of 46 patients (36 women; age 54.9 ± 11.7 years) with major depression who had been prospectively observed over a ten-year period to assess the risk of developing Parkinson's disease. At study entry, all patients underwent transcranial B-mode sonography to grade the echogenicity of the midbrain raphe and substantia nigra. The outcome measure was the first occurrence of violent suicidal behavior, i.e. a serious suicide attempt or completed suicide.At baseline, four patients were found to have grade 1 raphe echogenicity (invisible), 23 had grade 2 (weakly echogenic), and 19 had normal grade 3 (strongly echogenic). The visually graded echogenicity correlated well with the digitally analyzed echo-intensity (p < 0.001). Three (75%) patients with echogenicity grade 1 subsequently attempted or completed suicide, as did five (22%) with grade 2, but none with grade 3 (Kaplan-Meier analysis, log-rank test, p < 0.001). The latency period did not differ between echogenicity grade 1 and 2 (34.7 ± 30.9 vs. 22.6 ± 19.7 months, p = 0.59). Overall, patients with reduced raphe echogenicity were less likely to be free of subsequent violent suicidal behavior (3 years: RR, 0.78; 95% CI, 0.64-0.95; p = 0.034; 10 years: 0.70; 0.55-0.90; p = 0.014). No sex differences were found. Echogenicity of the substantia nigra did not improve the prediction of suicidal behavior.Reduced echogenicity of the midbrain raphe indicates an increased risk of subsequent violent suicidal behavior in patients with major depression.
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000284362 650_7 $$2Other$$aDepressive disorder
000284362 650_7 $$2Other$$aDiagnostic ultrasound
000284362 650_7 $$2Other$$aFatal suicide
000284362 650_7 $$2Other$$aMidbrain raphe
000284362 650_7 $$2Other$$aSubstantia nigra
000284362 650_7 $$2Other$$aSuicide prevention
000284362 650_2 $$2MeSH$$aHumans
000284362 650_2 $$2MeSH$$aFemale
000284362 650_2 $$2MeSH$$aMale
000284362 650_2 $$2MeSH$$aMajor Depressive Disorder: diagnostic imaging
000284362 650_2 $$2MeSH$$aMajor Depressive Disorder: psychology
000284362 650_2 $$2MeSH$$aMiddle Aged
000284362 650_2 $$2MeSH$$aUltrasonography, Doppler, Transcranial
000284362 650_2 $$2MeSH$$aSuicide, Attempted: psychology
000284362 650_2 $$2MeSH$$aSuicide, Attempted: statistics & numerical data
000284362 650_2 $$2MeSH$$aRetrospective Studies
000284362 650_2 $$2MeSH$$aRaphe Nuclei: diagnostic imaging
000284362 650_2 $$2MeSH$$aAdult
000284362 650_2 $$2MeSH$$aSuicide, Completed: psychology
000284362 650_2 $$2MeSH$$aSuicide, Completed: statistics & numerical data
000284362 650_2 $$2MeSH$$aAged
000284362 650_2 $$2MeSH$$aSubstantia Nigra: diagnostic imaging
000284362 650_2 $$2MeSH$$aRisk Factors
000284362 650_2 $$2MeSH$$aViolence: psychology
000284362 650_2 $$2MeSH$$aParkinson Disease: diagnostic imaging
000284362 7001_ $$aKaulitz, Lara$$b1
000284362 7001_ $$aHeilmann, Robert$$b2
000284362 7001_ $$aŠkoloudík, David$$b3
000284362 7001_ $$aHöppner-Buchmann, Jacqueline$$b4
000284362 773__ $$0PERI:(DE-600)1500487-9$$a10.1016/j.jad.2026.121175$$gVol. 399, p. 121175 -$$p121175$$tJournal of affective disorders$$v399$$x0165-0327$$y2026
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