Combined biological tests for suicide prediction.
Disturbances in serotonin neuroregulation and in hypothalamic-pituitary-adrenal axis activity are both likely, and possibly independent, factors in the genesis of suicidal behavior. This analysis considers whether clinically accessible measures of these two disturbances have additive value in the estimation of risk for suicide. Seventy-four inpatients with RDC major or schizoaffective depressive disorders entered a prospective follow-up study from 1978-1981, underwent a dexamethasone suppression test (DST) and had fasting serum cholesterol levels available in the medical record. As reported earlier, patients who had had an abnormal DST result were significantly more likely to commit suicide during follow-up. Serum cholesterol concentrations did not differ by DST result and low cholesterol values were associated with subsequent suicide when age was included as a covariate. These results indicate that, with the use of age-appropriate thresholds, serum cholesterol concentrations may be combined with DST results to provide a clinically useful estimate of suicide risk.
Coryell
William
W
Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, 2-205 MEB, Iowa City, IA 52242-1000, USA. william-coryell@uiowa.edu
Schlesser
Michael
M
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood* / Q000175:diagnosis / Q000523:psychology; D002784:Cholesterol / Q000097:blood*; D003865:Major Depressive Disorder / Q000097:blood* / Q000175:diagnosis / Q000523:psychology; D003907:Dexamethasone; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000097:blood* / Q000175:diagnosis / Q000523:psychology; D018570:Risk Assessment; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D016019:Survival Analysis; D000092864:Suicide Prevention
D015415:Biomarkers; D005938:Glucocorticoids; D003907:Dexamethasone; D002784:Cholesterol; D006854:Hydrocortisone