Morfología de los Potenciales Evocados Auditivos de Latencia Tardía P300 y su Rol en la Evaluación de la Conducta Suicida

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Abstract

RESUMEN: El suicidio es un problema de salud a nivel mundial, siendo la conducta suicida uno de los predictores de mortalidad por suicidio; sin embargo, su valoración aún sigue siendo compleja. Aunque la cantidad de literatura que ha abordado distintas perspectivas de la conducta suicida es abundante, se requiere ahondar en nuevos métodos que permitan una valoración rápida y objetiva de ésta, proporcionando a los clínicos y pacientes, un sistema de evaluación que registre los cambios de estados emocionales de manera dinámica. El objetivo de este manuscrito fue proporcionar una visión general de la morfología de los potenciales evocados auditivos de latencia tardía p300 y su rol en la evaluación de la conducta suicida.

Translated abstract

SUMMARY: Suicide is a global health problem, with suicidal behavior being one of the predictors of suicide mortality; however, its assessment is still complex. Although the amount of literature that has addressed different perspectives of suicidal behavior is abundant, it is necessary to deepen new methods that allow a rapid and objective assessment of it, providing clinicians and patients with an evaluation system that allows changes in emotional state to be recorded dynamically. The aim of this manuscript was to provide an overview of morphological patterns of auditory evoked potential P300 latency late in the assessment of suicidal behavior.

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Most cited references 33

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Clinical application of the P300 event-related brain potential.

John Polich (2004)

The P300 brain potential can provide information about cognition that is quantitatively comparable to other clinically used biomedical assays. Causes of P300 variability with respect to task and biologic determinants have been well characterized so that refinement of ERP methods for clinical applications is possible. Elaboration of how P300 and other ERP components reflect neuropsychologic processes would help to increase their clinical relevance. In particular, development of reliable P3a paradigms used in conjunction with P3b tasks promises to augment dramatically the applicability and sensitivity of ERPs. Use of P300 as a clinical evaluation tool should be revisited with contemporary theory, methods, and analysis procedures because a reliable neuroelectric measure of mental function would redefine the assessment of cognitive disorders.

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Suicide risk assessment in clinical practice: pragmatic guidelines for imperfect assessments.

James Christopher Fowler (2012)

This practice review focuses on the challenges of conducting sensitive and accurate assessments of the relative risk for suicide attempts and completed suicides. Suicide and suicide attempts are a frequently encountered clinical crisis, and the assessment, management, and treatment of suicidal patients is one of the most stressful tasks for clinicians. An array of risk factors, warning signs, and protective factors associated with suicide risk are reviewed; however, we are not yet in possession of evidence-based diagnostic tests that can accurately predict suicide risk on an individual level without also creating an inordinate number of false-positive predictions. Given the current limitations of assessment strategies, clinicians are advised to keep in mind that patients contemplating suicide are under enormous psychological distress, requiring sensitive and thoughtful engagement during the assessment process. An overarching goal of these assessments should be conducted within the therapeutic frame, in which efforts are made to enhance the therapeutic alliance by negotiating a collaborative approach to assessing risk and understanding why thoughts of suicide are so compelling. Within this treatment heuristic, the Suicide Assessment Five-step Evaluation and Triage (SAFE-T) is recommended as a pragmatic multidimensional assessment protocol incorporating the best known risk and protective factors.