ABLEnews Extra

                    Beware the Black Dog

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Neuroscience

   Keeping watch for the black dog
   Emma Young on a test that may identify potential suicides

More than half the people who commit suicide in the UK every year--in
1992, there were over four thousand--contact their doctor in the month
before their death but are sent home without treatment. Depression,
and even suicidal intent, are notoriously difficult to recognise. But
now the development of a simple blood test to identify people at
immediate risk of harming themselves could be just a few years away,
thanks to research presented at the meeting of the Society of
Neurosciences in Miami last month.

The neurotransmitter, serotonin, also known as 5-HT, is already known
to be connected with depression. Anti-depressants, such as Prozac,
work by boosting levels of 5-HT in the brain. Now, researchers at the
Columbia University College of Physicians and Surgeons in New York,
and the New York State Psychiatric Institute, have found that levels
of serotonin in a certain area of the brain--the orbital cortex, which
is involved in impulse control--are extremely low in people who have
comitted suicide. They also found a similar, "dose-dependent"
abnormality in those who attempt to kill themselves: the lower the
levels of serotonin in the orbital cortex, the more dangerous the
suicide attempt.

If, as has been suggested by other work on suicide and biochemical
changes, the serotonin drop is temporary and peaks in a short period
before an attempt, a test to detect this could identify people in
immediate danger. Although serotonin levels could not be measured
directly, the researchers hope that a blood test designed to measure
the body's ability to manufacture the neurotransmitter could be
developed.

The researchers point out that changes in serotonin levels alone are
not enough to induce a suicide attempt--stress, for example, also
plays a large part. Both factors are involved in depression, which
often goes unrecognised by doctors. And without effective diagnosis, a
patient would never reach the serotonin testing stage. But, as around
15 per cent of all people who are diagnosed as clinically depressed do
commit suicide, such a test could identify those at most risk, and by
targeting them for extra treatment, possibly still save thousands of
lives.

[December 1, 1994]

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