Imaging of the suicidal brain in schizophrenia

Brain imaging is a non-invasive and direct in vivo estimation of the detailed structure, functioning and molecular processes of the brain. The main objective of this study is to analyze structural differences between individuals at very high risk for suicide and individuals at very low risk for suicide. To this end, we will recruit two groups of patients, assessing structural alterations of the brains of individuals with suicide attempt (SA) and without SA respectively. We will perform structural neuroimaging techniques assessing only individuals with schizophrenia (SCZ). We have created a database at Centre for Addiction and Mental Health (CAMH) for 650 patients with SCZ well-characterized for SA and suicidal ideation (SI). From this database, we will select two groups of patients: one group at very high risk for suicide consisting of 20 patients with multiple SA (at least two lifetime) characterized by high medical damage (lethality), and another group at very low risk for suicide consisting of 20 patients with no SA lifetime, who never experienced suicidal ideation (SI) lifetime and have no family history of suicidal behavior. This is the first imaging study that will investigate the difference between high lethality violent suicide attempters and non-suicidal ideators in the SCZ population. Identifying imaging biomarkers and mechanisms that modulate SA and SI in SCZ may enhance our understanding of the pathways resulting in suicide.