An exploratory magnetic resonance imaging study of suicidal ideation in individuals at clinical high-risk for psychosis

Psychiatry Res Neuroimaging. 2021 Jun 30:312:111287. doi: 10.1016/j.pscychresns.2021.111287. Epub 2021 Apr 7.


Suicide is a major cause of death in psychosis and associated with significant morbidity. Suicidal ideation (SI) is very common in those at clinical high-risk for psychosis (CHR) and predicts later suicide. Despite substantial work on the pathobiology of suicide in schizophrenia, little is known of its neurobiological underpinnings in the CHR or putatively prodromal state. Therefore, in this pilot study, we examined the neurobiology of SI in CHR individuals using structural MRI. Subjects were aged 14-30 and met criteria for the Attenuated Positive Symptom Psychosis-Risk Syndrome (APSS) delineated in the Structured Interview for Psychosis-Risk Syndromes (SIPS). Suicidality was assessed using the Columbia Suicide Severity Rating Scale (C-SSRS). Volumetric MRI scans were obtained on a 3T Phillips scanner. MRI data were available for 69 individuals (19 CHR without SI, 31 CHR with SI and 19 healthy control subjects). CHR individuals with SI had thicker middle temporal and right insular cortices than CHR individuals without SI and healthy control subjects. The location of these findings is consistent with neurobiological findings regarding suicide in syndromal psychosis. These findings underscore the potential for the use of brain imaging biomarkers of suicide risk in CHR individuals.

Keywords: Attenuated positive symptoms; Clinical high-risk for psychosis; MRI; Magnetic resonance imaging; Psychosis; Suicidal ideation; Suicide.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Humans
  • Magnetic Resonance Imaging
  • Pilot Projects
  • Prodromal Symptoms
  • Psychotic Disorders* / diagnostic imaging
  • Suicidal Ideation*
  • Young Adult