White matter hyperintensities and their associations with suicidality in psychiatrically hospitalized children and adolescents

Stefan Ehrlich, Gil G. Noam, In Kyoon Lyoo, Bae J. Kwon, Megan A. Clark, Perry F. Renshaw

Research output: Contribution to journalArticlepeer-review

64 Scopus citations


Objective: Increasingly, researchers and clinicians are recognizing that there may be biological markers associated with increased risk of suicide. The objective of this study was to compare white matter hyperintensities in psychiatrically hospitalized children and youth with and without a history of suicide attempt while controlling for other variables. Method: White matter hyperintensities of 153 child and adolescent psychiatry inpatients were rated on T2-weighted magnetic resonance imaging scans using a modified Coffey scale. DSM-IV diagnosis, history of suicide attempt, and control variables such as gender, age, comorbid medical illnesses, developmental disorder, substance abuse, severity of mental illness, head injury, and possible cerebral hypoxia were obtained from discharge medical records. Results: Within the unipolar depression group (n = 48), white matter hyperintensities were significantly associated with a higher prevalence of past suicide attempts (Fisher exact test, p = .03). Logistic regression analysis confirmed this relationship, indicating that none of the control variables confounded our results and suggesting a specificity of 0.94. Conclusions: This is the first report of an increased prevalence of white matter hyperintensities in children and youth with unipolar depression and a history of suicide attempt. Replication and expansion of our preliminary findings could be of great clinical interest.

Original languageEnglish
Pages (from-to)770-776
Number of pages7
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number6
StatePublished - Jun 2004

Bibliographical note

Funding Information:
Supported by the American Foundation for Suicide Prevention, John Alden Trust, Klingenstein Third Generation Foundation, and the German National Merit Foundation. The authors thank Kyung Heup Ahn, Rosalind Alban, Holly Cronin, and Sioned Davis for help in the process of data collection and Phyllis Wentworth and Cheri Goldstein for editing.


  • Depression
  • Magnetic resonance imaging
  • Suicide
  • White matter hyperintensities


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