PDF(Pubmed)
Abstract：
We present the case of a 49-year-old man who was diagnosed with depressive disorder, with the first episode having a strong reactive factor. He was involuntarily admitted to a psychiatric hospital after a failed attempt at taking his own life, where he responded to psychotherapy and antidepressant therapy, as evidenced by a >60% reduction in his MADRS total score. He was discharged after 10 days of treatment, denied having suicidal ideations, and was motivated to follow the recommended outpatient care. The risk for suicide during hospitalization was also assessed using suicide risk assessment tools and psychological assessments, including projective tests. The patient underwent a follow-up examination with an outpatient psychiatrist on the 7th day after discharge, during which the suicide risk assessment tool was administered. The results indicated no acute suicide risk or worsening of depressive symptoms. On the 10th day after discharge, the patient took his own life by jumping out of the window of his flat. We believe that the patient had dissimulated his symptoms and possessed suicidal ideations, which were not detected despite repeated examinations specifically designed to assess suicidality and depression symptoms. We retrospectively analyzed his quantitative electroencephalography (QEEG) records to evaluate the change in prefrontal theta cordance as a potentially promising biomarker of suicidality, given the inconclusive results of studies published to date. An increase in prefrontal theta cordance value was found after the first week of antidepressant therapy and psychotherapy in contrast to the expected decrease due to the fading of depressive symptoms. As demonstrated by the provided case study, we hypothesized that prefrontal theta cordance may be an EEG indicator of a higher risk of non-responsive depression and suicidality despite therapeutic improvement.
摘要：
我们介绍了一个49岁的男性，他被诊断患有抑郁症，第一集有很强的反应因素。在试图自杀失败后，他不由自主地被送进了精神病院，在那里他对心理治疗和抗抑郁治疗有反应，他的MADRS总分降低了>60%。治疗10天后出院,否认有自杀意念,并有动力遵循推荐的门诊护理。住院期间自杀的风险也使用自杀风险评估工具和心理评估，包括投射测试。患者在出院后第7天接受了门诊精神病医生的随访检查,期间使用自杀风险评估工具.结果表明没有急性自杀风险或抑郁症状恶化。出院后第10天,病人从公寓的窗户跳出去，结束了自己的生命。我们认为该患者表现出了自己的症状并有自杀念头，尽管专门设计用于评估自杀和抑郁症状的反复检查，但未检测到。我们回顾性分析了他的定量脑电图（QEEG）记录，以评估前额叶θ的变化作为自杀的潜在有希望的生物标志物，鉴于迄今为止发表的研究结果尚无定论。在抗抑郁药治疗和心理治疗的第一周后，发现前额叶θ调和值增加，而由于抑郁症状的消退而预期减少。正如所提供的案例研究所证明的那样，我们假设尽管治疗有所改善,但前额叶θ一致可能是较高的无反应性抑郁和自杀风险的脑电图指标.
