Biochemistry and suicidal behavior in depressed patients

Secunda, Steven K.; Cross, Christine K.; Koslow, Stephen H.; Katz, Martin Μ.; Kocsis, James H.; Maas, James W.; Landis, Harold

doi:10.1016/0006-3223(86)90241-6

Cited by 82 publications

(37 citation statements)

References 28 publications

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“…In contrast, no difference in HPA-axis function was detected when suicidal and non-suicidal depressed patients were compared using either the DST only (Brown et al, 1986), or the DST plus measurements of CSF-CRH and urinary cortisol (Roy, 1992). In line with the results of the present paper, some other studies have shown a relative hypoactivity of the HPA-axis in depressed patients manifesting suicidal behaviour and ideation (Secunda et al, 1986;Pfennig et al, 2005). In the more recent study by Pfennig and colleagues, the combined dexamethasone suppression/CRH stimulation test was used, which has been suggested to be more sensitive to changes in the HPA axis than the DST (Heuser et al, 1994).…”

Section: Our Results In Relation To Other Studiessupporting

confidence: 88%

“…Low 24-hour urinary cortisol is associated with adverse events during early life in the same patient material (Sunnqvist et al, In press). In line with these results, studies from other groups also demonstrate that suicidal patients may display decreased levels of cortisol (Secunda et al, 1986;Pfennig et al, 2005). However, in contrast some studies indicate that HPA-hyperactivity is associated with suicidal behavior (Lopez-Ibor et al, 1985;Westrin and Nimeus, 2003) and completed suicide (Yerevanian et al, 2004;Coryell et al, 2006;Jokinen et al, 2007).…”

Section: Introductionsupporting

confidence: 53%

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Salivary cortisol and suicidal behavior—A follow-up study

Lindqvist

Isaksson

Lil-Träskman-Bendz

et al. 2008

Psychoneuroendocrinology

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IntroductionHyperactivity of the Hypothalamic-Pituitary-Adrenal (HPA) axis is a common finding in Major DepressiveDisorder. 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. MethodsThirty-five suicide attempters and 16 non-suicidal controls were admitted to a psychiatric ward between the years of 1986 an 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. ResultsAt 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. ConclusionWe 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.

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Section: Our Results In Relation To Other Studiessupporting

confidence: 88%

Section: Introductionsupporting

confidence: 53%

Salivary cortisol and suicidal behavior—A follow-up study

Lindqvist

Isaksson

Lil-Träskman-Bendz

et al. 2008

Psychoneuroendocrinology

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“…In other words, the chronicity of stress, concomitant anxiety, and persistent tendency to suppress tics on a daily basis may take a biological toll, resulting in reduced levels of cortisol by the end of the day. As noted, lower evening cortisol has been reported in conditions of chronic stress (Nickel et al, 2007;Nicolson & van Diest, 2000;Ockenfels et al, 1995;Secunda et al, 1986), and reduced circadian rhythms have been rather consistently reported in PTSD (Yehuda, Boisoneau et al, 1995;Yehuda, Kahana et al, 1995;Yehuda, Resnick et al, 1993;Yehuda, Southwick et al, 1993;Yehuda et al, 1994). It may be the case that an enhanced negative feedback mechanism is part of the pathophysiology in some individuals with TS, as has been proposed for PTSD (Yehuda, Boisoneau et al, 1995).…”

Section: Discussionmentioning

confidence: 89%

“…The evening values for the groups revealed a trend level for group in that individuals with TS tended to have lower evening cortisol. A lower evening cortisol profile has been reported in conditions of chronic stress (Nickel et al, 2007;Nicolson & van Diest, 2000;Ockenfels et al, 1995), including chronic fatigue syndrome (Strickland et al, 1998), and some cases of severe depression (Secunda et al, 1986). The reduced evening cortisol levels in the children with TS may thus be the result of chronic daily stress.…”

Section: Discussionmentioning

confidence: 94%

Examining cortisol rhythmicity and responsivity to stress in children with Tourette syndrome

Corbett

Mendoza

Baym

et al. 2008

Psychoneuroendocrinology

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“…Ostroff et al [1] found a lower 24-hour urinary norepinephrine-to-epinephrine ratio in three depressive patients with a history of severe suicide attempts compared to depressed nonattempters. In 1986, Secunda et al [2] showed smaller urinary outputs of the norepinephrine metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) and a lower plasma concentration of MHPG in suicide attempters compared to patients without a history of suicidal behavior. Garvey et al [3] described a weak tendency for an association between urinary MHPG concentrations and the current suicide risk in a sample of depressed women.…”

Section: Introductionmentioning

confidence: 99%

Alpha-2-Adrenoreceptors in Depressed Suicide Attempters: Relationship with Medical Lethality of the Attempt

Pitchot¹,

Hansenne²,

Pinto³

et al. 2001

Neuropsychobiology

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Several lines of evidence tend to suggest a role for noradrenaline, and more specifically alpha-2-adrenoreceptors, in the biology of suicidal behavior. The purpose of this study was to assess the growth hormone (GH) response to clonidine, an alpha-2-adrenergic agonist, in majorly depressed inpatients with a history of highly lethal suicide attempt compared to depressed patients with a history of low lethal suicide attempt and nonattempters. Our sample included 20 male depressed inpatients with a history of suicide attempt compared to 20 male depressed nonattempters. We did not observe any significant difference between suicide attempters and nonattempters for GH peak values (2.4 ± 2.9 vs. 4.1 ± 3.7 ng/ml; F = 2.52, d.f. = 1, 38, p = 0.12). Moreover, GH peak responses to clonidine were not related to the degree of lethality of the attempt. The results of the present study do not support a major role for noradrenaline in the biology of suicidal behavior.

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Biochemistry and suicidal behavior in depressed patients

Cited by 82 publications

References 28 publications

Salivary cortisol and suicidal behavior—A follow-up study

Salivary cortisol and suicidal behavior—A follow-up study

Examining cortisol rhythmicity and responsivity to stress in children with Tourette syndrome

Alpha-2-Adrenoreceptors in Depressed Suicide Attempters: Relationship with Medical Lethality of the Attempt

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