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Salivary cortisol and suicidal behavior-A follow-up study.

Lindqvist, Daniel LU ; Isaksson, Anders LU ; Träskman Bendz, Lil LU and Brundin, Lena LU (2008) In Psychoneuroendocrinology 33(8). p.1061-1068
Abstract
INTRODUCTION: Hyperactivity of the hypothalamic-pituitary-adrenal (HPA)-axis is a common finding in major depressive disorder. Similar studies on suicide attempters are less abundant, and the results are divergent. The main aim of the present study was to investigate HPA-axis parameters by the time of a suicide attempt and at follow-up in search for associations between HPA-axis function and suicidal behavior. METHODS: Thirty-five suicide attempters and 16 non-suicidal controls were admitted to a psychiatric ward between the years of 1986 and 1992. Corticotrophin-releasing hormone (CRH) in cerebrospinal fluid and urinary cortisol were obtained for the suicide attempters. The patients were followed up approximately 12 years after the index... (More)
INTRODUCTION: Hyperactivity of the hypothalamic-pituitary-adrenal (HPA)-axis is a common finding in major depressive disorder. Similar studies on suicide attempters are less abundant, and the results are divergent. The main aim of the present study was to investigate HPA-axis parameters by the time of a suicide attempt and at follow-up in search for associations between HPA-axis function and suicidal behavior. METHODS: Thirty-five suicide attempters and 16 non-suicidal controls were admitted to a psychiatric ward between the years of 1986 and 1992. Corticotrophin-releasing hormone (CRH) in cerebrospinal fluid and urinary cortisol were obtained for the suicide attempters. The patients were followed up approximately 12 years after the index admission. Cortisol was measured in saliva, and additional suicide attempts and current psychiatric symptoms were registered. RESULTS: At follow-up, evening salivary cortisol was lower in suicide attempters compared to controls. Low cortisol levels at follow-up were associated with severe psychiatric symptoms. Among women, repeated suicide attempts were associated with low morning and lunch salivary cortisol, and in this subgroup we also found significant correlations between salivary cortisol at follow-up, and CRH as well as urinary cortisol at index. CONCLUSION: We found evidence for an association between low HPA-axis activity and suicidal behavior. This could be due to long-lasting and severe psychiatric morbidity, which in turn has exhausted the HPA-axis of these patients. The potential role of hypocortisolism should be given more attention in studies on suicidal patients. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
Psychoneuroendocrinology
volume
33
issue
8
pages
1061 - 1068
publisher
Elsevier
external identifiers
  • wos:000259583500004
  • pmid:18672335
  • scopus:49049088488
ISSN
1873-3360
DOI
10.1016/j.psyneuen.2008.05.012
language
English
LU publication?
yes
id
99b98570-48bd-4295-b77e-77ad2ee047ec (old id 1223568)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18672335?dopt=Abstract
date added to LUP
2008-09-10 11:58:29
date last changed
2017-09-10 04:46:37
@article{99b98570-48bd-4295-b77e-77ad2ee047ec,
  abstract     = {INTRODUCTION: Hyperactivity of the hypothalamic-pituitary-adrenal (HPA)-axis is a common finding in major depressive disorder. Similar studies on suicide attempters are less abundant, and the results are divergent. The main aim of the present study was to investigate HPA-axis parameters by the time of a suicide attempt and at follow-up in search for associations between HPA-axis function and suicidal behavior. METHODS: Thirty-five suicide attempters and 16 non-suicidal controls were admitted to a psychiatric ward between the years of 1986 and 1992. Corticotrophin-releasing hormone (CRH) in cerebrospinal fluid and urinary cortisol were obtained for the suicide attempters. The patients were followed up approximately 12 years after the index admission. Cortisol was measured in saliva, and additional suicide attempts and current psychiatric symptoms were registered. RESULTS: At follow-up, evening salivary cortisol was lower in suicide attempters compared to controls. Low cortisol levels at follow-up were associated with severe psychiatric symptoms. Among women, repeated suicide attempts were associated with low morning and lunch salivary cortisol, and in this subgroup we also found significant correlations between salivary cortisol at follow-up, and CRH as well as urinary cortisol at index. CONCLUSION: We found evidence for an association between low HPA-axis activity and suicidal behavior. This could be due to long-lasting and severe psychiatric morbidity, which in turn has exhausted the HPA-axis of these patients. The potential role of hypocortisolism should be given more attention in studies on suicidal patients.},
  author       = {Lindqvist, Daniel and Isaksson, Anders and Träskman Bendz, Lil and Brundin, Lena},
  issn         = {1873-3360},
  language     = {eng},
  number       = {8},
  pages        = {1061--1068},
  publisher    = {Elsevier},
  series       = {Psychoneuroendocrinology},
  title        = {Salivary cortisol and suicidal behavior-A follow-up study.},
  url          = {http://dx.doi.org/10.1016/j.psyneuen.2008.05.012},
  volume       = {33},
  year         = {2008},
}