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Blood hormones and suicidal behaviour: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 139:104725. [PMID: 35690122 DOI: 10.1016/j.neubiorev.2022.104725] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 12/28/2022]
Abstract
This study was to evaluate the relationship between blood hormone levels and suicidal behaviour. We reviewed Web of Science, PubMed and Embase for literature published up to 10 April 2022. Studies were restricted to English-language articles. Studies measuring blood hormone levels in suicidal and non-suicidal subjects were eligible. Standardized mean differences (SMDs) were applied to evaluate group differences. Overall, 57 studies were eligible, of which 51 evaluated suicide attempts, and 9 assessed suicidal ideation. Random-effects meta-analysis indicated that levels of thyrotropin stimulating hormone (TSH) (SMD = 0.50; 95% CI, 0.27-0.72), leptin (SMD = -1.16; 95% CI, -1.94 to -0.38) and dehydroepiandrosterone sulfate (DHEAS) (SMD = -0.67; 95% CI, -1.13 to -0.21) were related to suicide attempts, whereas progesterone levels (SMD = 0.22; 95% CI, 0.03-0.41) were related to suicidal ideation. This analysis offers evidence linking abnormalities of blood hormones with suicidal behaviour, which may be essential for identifying individuals with suicide attempts and suicidal ideation. Large prospective studies are needed for further clarification of roles of hormones in suicidal behaviour.
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Johnston JN, Campbell D, Caruncho HJ, Henter ID, Ballard ED, Zarate CA. Suicide Biomarkers to Predict Risk, Classify Diagnostic Subtypes, and Identify Novel Therapeutic Targets: 5 Years of Promising Research. Int J Neuropsychopharmacol 2022; 25:197-214. [PMID: 34865007 PMCID: PMC8929755 DOI: 10.1093/ijnp/pyab083] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/02/2021] [Accepted: 11/30/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Suicide is a global health crisis. However, no objective biomarkers of suicide risk currently exist, and self-reported data can be unreliable, which limits prediction, diagnostic, and treatment efforts. Reliable biomarkers that can differentiate between diagnostic subgroups, predict worsening symptoms, or suggest novel therapeutic targets would be extremely valuable for patients, researchers, and clinicians. METHODS MEDLINE was searched for reports published between 2016 and 2021 using search terms (suicid*) AND (biomarker*) OR (indicat*). Reports that compared biomarkers between suicidal ideation, suicide attempt, death from suicide, or any suicide subgroup against other neuropsychiatric disorders were included. Studies exclusively comparing suicidal behavior or death from suicide with healthy controls were not included to ensure that biomarkers were specific to suicide and not other psychopathology. RESULTS This review summarizes the last 5 years of research into suicide-associated biomarkers and provides a comprehensive guide for promising and novel biomarkers that encompass varying presentations of suicidal ideation, suicide attempt, and death by suicide. The serotonergic system, inflammation, hypothalamic-pituitary-adrenal axis, lipids, and endocannabinoids emerged as the most promising diagnostic, predictive, and therapeutic indicators. CONCLUSIONS The utility of diagnostic and predictive biomarkers is evident, particularly for suicide prevention. While larger-scale studies and further in-depth research are required, the last 5 years of research has uncovered essential biomarkers that could ultimately improve predictive strategies, aid diagnostics, and help develop future therapeutic targets.
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Affiliation(s)
- Jenessa N Johnston
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Darcy Campbell
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Hector J Caruncho
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Ioline D Henter
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Elizabeth D Ballard
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
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Genis-Mendoza AD, Dionisio-García DM, Gonzalez-Castro TB, Tovilla-Zaráte CA, Juárez-Rojop IE, López-Narváez ML, Castillo-Avila RG, Nicolini H. Increased Levels of Cortisol in Individuals With Suicide Attempt and Its Relation With the Number of Suicide Attempts and Depression. Front Psychiatry 2022; 13:912021. [PMID: 35757221 PMCID: PMC9226316 DOI: 10.3389/fpsyt.2022.912021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Abnormalities in the hypothalamic-pituitary-adrenal axis (HPA) have been reported in individuals with suicide behavior. The aim of the study was to evaluate cortisol levels in peripheral plasma of individuals with more than one suicide attempt. METHODS Cortisol concentrations in peripheral plasma were measured using the ELISA technique. Suicide attempts were evaluated by the Columbia Suicide Severity Rating Scale, while depression was evaluated by the Hamilton Depression Rating Scale. RESULTS We found elevated cortisol levels in the suicide attempt group when compared with healthy controls (F = 7.26, p-value = 0.008), but no statistical differences with the psychiatric diseases group (F = 1.49, p-value = 0.22). Cortisol levels were higher in individuals with depression (F = 8.99, P = 0.004) and in individuals with two or more suicide attempts (F = 13.56, P < 0.001). CONCLUSIONS Cortisol levels are increased in individuals who attempt suicide and higher of cortisol concentrations in plasma regard to depression and more attempts of suicide.
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Affiliation(s)
- Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico.,Hospital Psiquiátrico Infantil "Juan N. Navarro", Servicios de Atención Psiquiátrica, Mexico City, Mexico
| | | | - Thelma Beatriz Gonzalez-Castro
- División Académica Multidisciplinaria de Jalpa de Mendéz, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Mexico
| | | | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
| | - María Lilia López-Narváez
- Secretaria de Salud de Chiapas, Hospital Chiapas Nos une "Dr. Jesús Gilberto Gómez Maza", Tuxtla Gutiérrez, Mexico
| | | | - Humberto Nicolini
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico
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Mannekote Thippaiah S, Iyengar SS, Vinod KY. Exo- and Endo-cannabinoids in Depressive and Suicidal Behaviors. Front Psychiatry 2021; 12:636228. [PMID: 33967855 PMCID: PMC8102729 DOI: 10.3389/fpsyt.2021.636228] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Abstract
Cannabis (marijuana) has been known to humans for thousands of years but its neurophysiological effects were sparsely understood until recently. Preclinical and clinical studies in the past two decades have indisputably supported the clinical proposition that the endocannabinoid system plays an important role in the etiopathogeneses of many neuropsychiatric disorders, including mood and addictive disorders. In this review, we discuss the existing knowledge of exo- and endo-cannabinoids, and role of the endocannabinoid system in depressive and suicidal behavior. A dysfunction in this system, located in brain regions such as prefrontal cortex and limbic structures is implicated in mood regulation, impulsivity and decision-making, may increase the risk of negative mood and cognition as well as suicidality. The literature discussed here also suggests that the endocannabinoid system may be a viable target for treatments of these neuropsychiatric conditions.
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Affiliation(s)
- Srinagesh Mannekote Thippaiah
- Valleywise Behavioral Health, Phoenix, AZ, United States.,Creighton University School of Medicine, Phoenix, AZ, United States
| | - Sloka S Iyengar
- The American Museum of Natural History, New York, NY, United States
| | - K Yaragudri Vinod
- Department of Analytical Psychopharmacology, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States.,Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States.,Department of Child & Adolescent Psychiatry, New York University Langone Health, New York, NY, United States
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Kang M, Bohorquez-Montoya L, McAuliffe T, Claesges SA, Blair NO, Sauber G, Reynolds CF, Hillard CJ, Goveas JS. Loneliness, Circulating Endocannabinoid Concentrations, and Grief Trajectories in Bereaved Older Adults: A Longitudinal Study. Front Psychiatry 2021; 12:783187. [PMID: 34955928 PMCID: PMC8692767 DOI: 10.3389/fpsyt.2021.783187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Loneliness is one of the most distressing grief symptoms and is associated with adverse mental health in bereaved older adults. The endocannabinoid signaling (ECS) system is stress-responsive and circulating endocannabinoid (eCB) concentrations are elevated following bereavement. This study examined the association between loneliness and circulating eCB concentrations in grieving older adults and explored the role of eCBs on the association between baseline loneliness and grief symptom trajectories. Methods: A total of 64 adults [grief with high loneliness: n = 18; grief with low loneliness: n = 26; and healthy comparison (HC): n = 20] completed baseline clinical assessments for the UCLA loneliness scale. In grief participants, longitudinal clinical assessments, including the Inventory of Complicated Grief and 17-item Hamilton Depression Rating scales, were collected over 6 months. Baseline circulating eCB [N-arachidonoylethanolamine (AEA) and 2-arachidonoylglycerol (2-AG)] concentrations were quantified in the serum using isotope dilution, liquid chromatography-mass spectrometry; cortisol concentrations were measured in the same samples using radioimmunoassay. Results: Circulating AEA concentrations were higher in severely lonely grieving elders than in HC group; cortisol concentrations were not different among the groups. Cross-sectionally, loneliness scores were positively associated with AEA concentrations in grievers; this finding was not significant after accounting for depressive symptom severity. Grieving individuals who endorsed high loneliness and had higher 2-AG concentrations at baseline showed faster grief symptom resolution. Conclusions: These novel findings suggest that in lonely, bereaved elders, increased circulating eCBs, a reflection of an efficient ECS system, are associated with better adaptation to bereavement. Circulating eCBs as potential moderators and mediators of the loneliness-grief trajectory associations should be investigated.
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Affiliation(s)
- Minhi Kang
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Luisa Bohorquez-Montoya
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Timothy McAuliffe
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Stacy A Claesges
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Nutta-On Blair
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Garrett Sauber
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, United States.,Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Cecilia J Hillard
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, United States.,Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Joseph S Goveas
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States.,Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, United States
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deRoon-Cassini TA, Stollenwerk TM, Beatka M, Hillard CJ. Meet Your Stress Management Professionals: The Endocannabinoids. Trends Mol Med 2020; 26:953-968. [PMID: 32868170 DOI: 10.1016/j.molmed.2020.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/24/2020] [Accepted: 07/10/2020] [Indexed: 12/14/2022]
Abstract
The endocannabinoid signaling system (ECSS) is altered by exposure to stress and mediates and modulates the effects of stress on the brain. Considerable preclinical data support critical roles for the endocannabinoids and their target, the CB1 cannabinoid receptor, in the adaptation of the brain to repeated stress exposure. Chronic stress exposure increases vulnerability to mental illness, so the ECSS has attracted attention as a potential therapeutic target for the prevention and treatment of stress-related psychopathology. We discuss human genetic studies indicating that the ECSS contributes to risk for mental illness in those exposed to severe stress and trauma early in life, and we explore the potential difficulties in pharmacological manipulation of the ECSS.
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Affiliation(s)
- Terri A deRoon-Cassini
- Neuroscience Research Center, USA; Department of Surgery, Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Todd M Stollenwerk
- Neuroscience Research Center, USA; Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Margaret Beatka
- Neuroscience Research Center, USA; Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Cecilia J Hillard
- Neuroscience Research Center, USA; Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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Sher L. Neurobiology of suicidal behavior in combat veterans. BRAZILIAN JOURNAL OF PSYCHIATRY 2020; 42:465-466. [PMID: 32267346 PMCID: PMC7524409 DOI: 10.1590/1516-4446-2020-0877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Leo Sher
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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