Objective: Bipolar disorder is associated with high risk for suicidal behavior that often develops in adolescence and young adulthood. Elucidation of involved neural systems is critical for prevention. This study of adolescents and young adults with bipolar disorder with and without a history of suicide attempts combines structural, diffusion tensor, and functional MR imaging methods to investigate implicated abnormalities in the morphology and structural and functional connectivity within frontolimbic systems.
Method: The study had 26 participants with bipolar disorder who had a prior suicide attempt (the attempter group) and 42 participants with bipolar disorder without a suicide attempt (the nonattempter group). Regional gray matter volume, white matter integrity, and functional connectivity during processing of emotional stimuli were compared between groups, and differences were explored for relationships between imaging modalities and associations with suicide-related symptoms and behaviors.
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The participant will recognize the brain regions implicated in suicide behavior in adolescents and young adults with bipolar disorder.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Duration: 1 hour
Begin Date: July 1, 2017
End Date: June 30, 2019
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Title: Multimodal Neuroimaging of Frontolimbic Structure and Function Associated With Suicide Attempts in Adolescents and Young Adults With Bipolar Disorder
Authors: Jennifer A.Y. Johnston, M.A., Fei Wang, M.D., Ph.D., Jie Liu, Ph.D., Benjamin N. Blond, M.D., Amanda Wallace, M.D., Jiacheng Liu, M.D., Ph.D., Linda Spencer, B.S., Elizabeth T. Cox Lippard, Ph.D., Kirstin L. Purves, B.Sc., Angeli Landeros-Weisenberger, M.D., Eric Hermes, M.D., Brian Pittman, M.S., Sheng Zhang, Ph.D., Robert King, M.D., Andrés Martin, M.D., M.P.H., Maria A. Oquendo, M.D., Hilary P. Blumberg, M.D.
Affiliations: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn. (J.A.Y.J., F.W., J.L., B.N.B., A.W., J.L., L.S., E.T.C.L., K.L.P., A.L.-W., E.H., B.P., S.Z., R.K., A.M., H.P.B.); the Division of Psychology and Language Sciences, University College London (K.L.P.); and the Department of Psychiatry, Columbia University Medical Center, New York (M.A.O.).
Disclosures: Dr. Oquendo receives royalties for the commercial use of the Columbia Suicide Severity Rating Scale and an honorarium as president of APA, and her family owns stock in Bristol-Myers Squibb. Dr. Martin receives royalties from Wolters Kluwer and an editorial stipend from the American Academy of Child and Adolescent Psychiatry. The other authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
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