67 Self-help groups in programs for treatment and rehabilitation of addicts – Croatian model of psychiatry in community

Abstract

Recent TCS studies showed that disruption of echogenic midbrain line corresponding to basal limbic system and raphe nuclei (RN) within might represent functional marker for the development of depression (irrespective of diagnostic category). Also, depression is the most common psychiatric disorder associated with suicidal ideation. Still there is lack of evidence that, at patients with suicidal ideation, TCS might record same RN alteration. Therefore, we initiated this study to test the possibility of TCS to disclose suicidal risk at patients with major depressive disorder (MDD). Methods: Altogether 90 subjects: 30 patients with MDD, 30 patients with MDD who also reported suicidal ideation and 30 healthy controls where studied using TCS. Severity of the disease was measured according to Hamilton Depression Rating Scale (HDRS) and clinical global impression scale (CGI).Examination was performed by standardized semi quantitative protocol. Results: Reduced raphe echogenicity was found in 16 of 30 (53%) of the patients with MDD but only in 6 of 30 (20%) controls. In patients with suicidal ideations that finding was even more pronounced 22 of 30 (73%), with the highest frequency of completely not visible TCS RN finding 20 of 30 (67%). Conclusion: Our results showed that alteration of RN is frequent TCS finding in depressive states. That finding is rare in healthy subjects; however, in suicidal patients such alteration was even more pronounced. Finding of completely disrupted RN line was frequently associated with suicidal ideation. These data suggest that TCS might be novel method for the detection of patients with suicidal risk.