Rilevanza dell’abuso infantile nella psicopatologia delle condotte suicidarie

Background: Over the past three decades, a strong link has been reported between psychopathology and suicidal behaviour. The presence of a DSM-IV psychiatric diagnosis is present in up to 90% of patients that attempt suicide and major depression is the most common psychiatric disorder associated to suicide. In order for an individual to attempt suicide, the presence of depression may be necessary but is not sufficient since most patients with a depressive disorder never act a suicide attempt. It has been reported that certain psychopathological dimensions are more specifically related to suicidal behaviour than a psychiatric diagnosis. Aggression, impulsivity and childhood abuse are the most studied risk factors associated to suicide. Particularly, childhood trauma appears to be independently related to suicidal behaviour in depressed patients and is considered a strong vulnerability factor for suicide to occurr. Aggression and impulsivity, that are recognized as prevalent in their association with suicide, are also associated to childhood abuse. Method: We conducted a study on a sample of patients with Unipolar Major Depression, single episode or recurrent (N = 170), evaluating the presence and history of suicidality. Every patient has been submitted to a semistructured psychiatric interview and has been assessed with a series of psychometric tests. Childhood trauma questionnaire (CTQ) has been used in order to evaluate the history of sexual abuse; Brown Goodwin History of Aggression Scale (BGHA) was administered to evaluate subjects' aggressive tendencies and Barratt Impulsivity Scale (BIS) was used to determine impulsive traits. The hypothesis that has been tested was that suicidal subjects would report more childhood trauma. We also measured other psychopatological variables such as aggression, impulsivity and severity of depressive symptoms in order to evaluate correlations with childhood trauma and suicide attempts. Results: Suicidal patients were more frequently female, single, unemployed and highly educated. Suicide attempters also reported higher scores for emotional abuse, physical abuse and sexual abuse. Higher scores were also reported for aggression and impulsivity. Childhood trauma was significantly related with aggression, particularly in suicide attempters. No significant correlations could be found between CTQ scores, BGHA scores, BIS scores and number and fatures of suicide attempts (Tab. I). Conclusion: The results of our study confirm that childhood trauma, aggression and impulsivity may be considered risk factors for suicidal behaviour and their assessment could be useful in identifying patients at risk for suicide. Specific tools to recognize and treat childhood abuse victims may reduce suicide rates.