Neuroactive steroids and suicidality in posttraumatic stress disorder.
OBJECTIVE
Recent studies suggest that neuroactive steroids may be altered in posttraumatic stress disorder (PTSD). Since high rates of suicidality accompany PTSD, the authors investigated neuroactive steroid levels and correlations to suicide attempts in veterans with this disorder.


METHODS
Male veterans with PTSD enrolled in a larger study during inpatient hospitalization (N=130) were assessed for suicidal ideation or suicide attempt in the last 6 months. Serum levels of dehydroepiandrosterone (DHEA), androstenedione, testosterone, and estradiol were determined. The authors investigated associations between neuroactive steroids and suicidality.


RESULTS
High rates of suicidality were observed. Close to 70% of these patients had suicidal thoughts, and 25% had attempted suicide in the last 6 months. Patients who had attempted suicide demonstrated significantly higher median DHEA levels than those who had not attempted suicide (15.6 versus 8.3 ng/ml), an association that persisted after adjustment for age.


CONCLUSIONS
These findings suggest that higher DHEA levels may be linked to suicidality in veterans with PTSD and may be associated with the risk of self-harm.
Butterfield
Marian I
MI
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham Veterans Affairs medical Center, Durham, NC 27705, USA.
Stechuchak
Karen M
KM
Connor
Kathryn M
KM
Davidson
Jonathan R T
JR
Wang
Chungsheng
C
MacKuen
Courteney L
CL
Pearlstein
Anne M
AM
Marx
Christine E
CE
D000735:Androstenedione / Q000097:blood; D003687:Dehydroepiandrosterone / Q000097:blood*; D004958:Estradiol / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000453:epidemiology / Q000523:psychology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D013739:Testosterone / Q000097:blood; D014728:Veterans / Q000523:psychology
D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D004958:Estradiol