Distinct neural correlates between suicide attempters with major depressive disorder and other psychiatric disorders: a multimodal imaging study

Background: Suicide attempters (SA) with mild diagnoses other than major depressive disorder (MDD) are underexplored. This study aimed to investigate neuroimaging abnormalities in SA with MDD (SA-MDD), SA with other psychiatric disorders (OPD) (SA-OPD), and healthy controls (HC) using MRI data. Associations between altered findings in the patient groups and anger, negative schema, or rumination were further examined. Methods: We recruited SA who visited the emergency department and divided them into two groups: SA-MDD (n = 52) and SA-OPD (n = 24). Age-, sex-, and education-matched HC) (n = 100) participated in the study. Cortical thickness, surface area, and subcortical volume were measured using structural magnetic resonance imaging (MRI). Regional analysis and seed-based functional connectivity (FC) analyses were performed using resting-state functional MRI. Partial Pearson or Spearman correlation with psychological variables was conducted. Results: Widespread decreases in cortical thickness and larger cortical surface areas in some regions were observed in both SA-MDD and SA-OPD. However, decreased hippocampal volume was observed only in SA-MDD. Altered FC was more prominent in SA-MDD than in SA-OPD. In addition, significant associations between altered seed-based FC and negative schema were observed in both groups. Importantly, the associations with anger and rumination were evident only in SA-OPD. Conclusions: These findings suggest that SA-OPD have similar alterations in brain morphometry to SA-MDD but show less prominent FC alterations. The clinical implications of anger and rumination in SA-OPD warrant further investigation.