When studying the effects of different treatment and suicide prevention measures, it is of great importance to select those patients who are prepared to and capable to take their life and not to include patients who probably still would not take their life because of the protection by a normal neuropsychological orienting function.
• The method of Emotra is the only objective one that can manage to identify patients appropriate for such research.
Science in suicide becomes more and more focused on the damages and dysfunctions of the important brain structure hippocampus.
• The method of Emotra has, according to current theory, the potential to measure signs for suicide as a vital dysfunction in the hippocampus, irrespective of the cause.
Electrodermally hyporeactive persons do not react with normal curiosity about events in the everyday life.
• This leads to a condition of psychological preparedness to leave the life and capability to perform an attempt to do it which makes hyporeactives very vulnerable for suicide.
Electrodermally hyporeactive persons have difficulties to build clear memories of events in daily life. This may in turn lead to other cognitive dysfunctions, which can contribute to and worsen depression and quality of life.
• Emotra’s method is an objective functional method that could reveal deep neuropsychological causes of these dysfunctions.
Electrodermally reactivity tends to convert into hyporeactivity in next or later episodes of depression.
• Emotra’s method may be a tool to study the assumed brain damages that are believed to occur in recurrent depression.
EUDOR – A
The clinical study EUDOR-A – A Naturalistic Multi-centre Clinical Study of EDOR Test in adult patients with primary depression Study Program, was initiated.
The study is organised and monitored by Emotra in close cooperation with Professor Marco Sarchiapone, Molise, Italy
In total 18 scientific institutions from ten European countries are cooperating in order to complete this study. More than 1500 patients have now been tested and 15 clinical centres have regularly reported EDOR Test data to the Emotra analysis centre in Sweden. In March 2016 the reporting of new test data was closed. All patients will be followed up after 12 months. A direct comparison in number of suicide or suicide attempts, between those patients who reacted normally to the test and those who were identified as being hyporeactive, will be performed. The main purpose with the study is to demonstrate the strong relation between hyporeactivity and suicide risk.
The clinical teams responsible for the patients have, due to ethical reasons, been informed about the results from the individual tests. Obviously this implies a risk for affecting the study results in a negative way. If effective suicide protection are offered to the hyporeactive patients, it might prevent possible suicide events. The objective with the study is however also to demonstrate that patients who have shown a normal reactivity in the test, and thus are judged not to be at risk, does not commit suicide or suicide attempt. The overall judgement is that EDOR is accurate enough and thus the differences between the two groups, patients with normal reactivity and hyporeactive patients, are expected to be clearly demonstrated in the study.
The 10th of March 2017, the study will be finalized and the results will be analysed and statistically evaluated. After that the study results will be reported in one or several scientific papers. A consensus meeting will be arranged in which all involved clinical and research teams will participate and discus their experiences and the conclusions that can be drawn from the study. The idea is also that the group, after careful discussions and considerations, should agree on a consensus statement.
A selection of scientific references
- Edman G, Åsberg M, Levander S, Schalling D. Skin conductance habituation and cerebrospinal fluid 5-hydroxyindoleatic acid in suicidal patients. Arch Gen Psychiatry 1986; 43: 586–592.
- Thorell LH. Electrodermal activity in suicidal and non-suicidal depressive patients and in matched healthy subjects. Acta Psychiatrica Scandinavica 1987; 76: 420-430.
- Thorell LH, d’Elia G. Electrodermal activity in depressive patients in remission and in matched healthy subjects. Acta Psychiatr Scand. 1988;78:247-53.
- Thorell LH, Kjellman BF, d’Elia G. Electrodermal activity in antidepressant medicated and unmedicated depressive patients and in matched healthy subjects. Acta Psychiatrica Scandinavica 1987:76:684-692.
- Thorell LH, Kjellman BF, d’Elia G. Electrodermal activity in relation to diagnostic subgroups and symptomatology of depressive patients. Acta Psychiatrica Scandinavica 1987:76:693-701.
- Keller FM, Wolfersdorf M, Straub R, Hole G. Suicidal behaviour and electrodermal activity in depressive inpatients. Acta Psychiatrica Scandinavica 1991; 83:324–328.
- Wolfersdorf M, Straub R, Hole G. Electrodermal activity in depressive men and women with violent or non-violent suicide attempts. Schweizer Archiv für Neurologie und Psychiatrie 1993; 144:173–184.1
- Wolfersdorf M, Straub R. Electrodermal reactivity in male and female depressive patients who later died by suicide. Acta Psychiatr Scand 1994; 89: 279–284.
- Diepers M. Zur Suizidalität in der Depression: Persönlichkeitsmerkmale und psychophysiologische Reaktionsmunster. [Personality traits and psychophysiological reaction pattern.] Dissertation. Ulm: Universität Ulm, 1994.
- Wolfersdorf M, Straub R, Keller F, Barg T. Elektrodermale Reaktivität bei Suizidversuch und Suizid Depressiver. [Electrodermal reactivity in suicide attempts and suicide in depressives.] In: Wolfersdorf M, Kaschka WP, eds. Suizid – Die biologische Dimension. [Suicide – the biological dimension] Berlin: Heidelberg, 1995; 99–110.
- Wolfersdorf M, Straub R, Barg T, Keller F. Depression und EDA-Kennwerte in einem Habituationsexperiment. Ergebnisse bei über 400 stationären depressiven Patienten. [Depression and electrodermal characteristics in a habituation experiment. Results from more than 400 depressive inpatients.] Fortschr Neurol Psychiatr 1996; 64: 105–109.
- Eriksson T, Nilsson M, Rawanduzi S, Thorell LH. Implementering av psykofysiologisk suicidriskdetektion vid Redakliniken AB, Linköping hösten 2007 – våren 2008. [Implementation of psychophysiological suicide risk detection at the Reda Clinic.] Landstinget i Östergötland [County of Östergötland], Redakliniken AB, 2008.
- Thorell LH. Valid electrodermal hyporeactivity for depressive suicidal propensity offers links to cognitive theory. Acta Psychiatrica Scandinavica 2009; 119: 338-349.
- Thorell LH, Wolfersdorf M, Straub R, Steyer J, Hodgkinson S, Kaschka WP, Jandl M. Electrodermal hyporeactivity as a trait marker for suicidal propensity in uni- and bipolar depression. Insänt för publikation 2013.
- Thorell LH, Eriksson T. Skyddar fysiologiskt mätbar nyfikenhet den deprimerade mot självmord? Manuskript för publikation, 2013.