Self-Referential Thinking, Suicide, and Function of the Cortical Midline Structures and Striatum in Mood Disorders : Possible Implications for Treatment Studies of Mindfulness-Based Interventions for Bipolar Depression

Abstract EN

Bipolar depression is often refractory to treatment and is frequently associated with anxiety symptoms and elevated suicide risk.

There is a great need for adjunctive psychotherapeutic interventions.

Treatments with effectiveness for depressive and anxiety symptoms as well as suicide-related thoughts and behaviors would be particularly beneficial.

Mindfulness-based interventions hold promise, and studies of these approaches for bipolar disorder are warranted.

The aim of this paper is to provide a conceptual background for such studies by reviewing key findings from diverse lines of investigation.

Results of that review indicate that cortical midline structures (CMS) appear to link abnormal self-referential thinking to emotional dysregulation in mood disorders.

Furthermore, CMS and striatal dysfunction may play a role in the neuropathology underlying suicide-related thoughts and behaviors.

Thus, combining studies of mindfulness interventions targeting abnormal self-referential thinking with functional imaging of CMS and striatal function may help delineate the neurobiological mechanisms of action of these treatments.