RESUMO
OBJECTIVE: Childhood maltreatment (CM) is a significant risk factor for the development and severity of bipolar disorder (BD) with increased risk of suicide attempts (SA). This study evaluated whether a machine learning algorithm could be trained to predict if a patient with BD has a history of CM or previous SA based on brain metabolism measured by positron emission tomography. METHODS: Thirty-six euthymic patients diagnosed with BD type I, with and without a history of CM were assessed using the Childhood Trauma Questionnaire. Suicide attempts were assessed through the Mini International Neuropsychiatric Interview (MINI-Plus) and a semi-structured interview. Resting-state positron emission tomography with 18F-fluorodeoxyglucose was conducted, electing only grey matter voxels through the Statistical Parametric Mapping toolbox. Imaging analysis was performed using a supervised machine learning approach following Gaussian Process Classification. RESULTS: Patients were divided into 18 participants with a history of CM and 18 participants without it, along with 18 individuals with previous SA and 18 individuals without such history. The predictions for CM and SA were not significant (accuracy = 41.67%; p = 0.879). CONCLUSION: Further investigation is needed to improve the accuracy of machine learning, as its predictive qualities could potentially be highly useful in determining histories and possible outcomes of high-risk psychiatric patients.
Assuntos
Transtorno Bipolar , Maus-Tratos Infantis , Humanos , Criança , Transtorno Bipolar/diagnóstico por imagem , Transtorno Bipolar/psicologia , Tentativa de Suicídio , Ideação Suicida , Tomografia por Emissão de Pósitrons , Encéfalo/diagnóstico por imagem , Aprendizado de Máquina , Maus-Tratos Infantis/psicologiaRESUMO
Durante el proceso de envejecimiento se producen una serie de cambios que a veces pueden sorprender desfavorablemente a aquellos individuos más frágiles. La pérdida de la continuidad identitaria constituye uno de los retos más significativos de los muchos que se presentan en la vejez y puede ocasionar imprevisibles consecuencias, entre las cuales la tentativa de suicidio aparecería como una manera última y desesperada de recuperar el control perdido. La vejez trae aparejados diversos cambios, que no son vividos de igual manera por todos; la característica de cada pérdida o de cada alteración determinará la repercusión en cada uno; por eso, poder comprenderlos en esta vivencia nos permite abrirnos hacia un nuevo entendimiento de esta etapa de la vida. A través de ella analizaremos tres historias de personas que perdieron en el camino aquello que las definía como seres humanos. (AU)
During the aging process several changes occur that may surprise unfavorably those who are more fragile. One of the most significant challenges that occur in the elderly is related with the lost of the previous identity which can lead to unforeseeable consequences, where the suicide attempt may seem to be the last and the most desperate way to regain control. Old age involves various changes and losses which will be experienced differently by every person according to their one personality and life story. To be able to fully comprehend this process will allow us to understand this stage of life in each singularity. In this article we will analyze three life stories illustrating people who lost the meaning of what defined them as human beings. (AU)