Pupillary light reflex may predict suicide risk in psychiatric patients, Study.
Suicide remains highly prevalent in patients with psychotic and mood disorders. An impediment to suicide prevention efforts is the lack of practical biomarkers of imminent risk of suicidal ideation/behavior/death (SIB).
In this regard, it has been suggested that hyperarousal—a state of increased physiologic arousal, which may manifest as insomnia, hypervigilance, agitation, and/or irritability—is mediated in part by both noradrenergic (NE) and cholinergic (ACh) systems and a potential marker for SIB.
A study published in Schizophrenia Research journal by Brian J. Miller et al. indicates that the pupillary light reflex (PLR) is a candidate marker of physiologic arousal, as proximal control of pupillary constriction and dilation is governed by acetylcholine (Ach) and norepineohrine (NE), respectively.
The researchers recruited 26 patients with schizophrenia and 42 with major depressive disorder (MDD) age 18–60 years. None of the subjects had a history of alcohol or substance use disorder, and all were free of medications with strong effects on the NE or ACh systems. 2 patients with schizophrenia were psychotropic-free, 4 were treated with first-generation and 20 with non-clozapine second-generation antipsychotics.
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