The prevalence, metabolic disturbances and clinical correlates of recent suicide attempts in Chinese inpatients with major depressive disorder

Abstract

Background: Metabolic disturbances have been correlated with suicidality, but little is known about the association between suicide risk and metabolic disturbances among individuals with depression. This study was to evaluate the prevalence and clinical correlations, especially cardio-metabolic associated factors of recent suicide attempts in Chinese patients with major depressive disorder (MDD). Methods: A total of 288 MDD inpatients were recruited. Their clinical and demographic data together with plasma glucose, lipid and thyroid function parameters were collected. Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and Eysenck Personality Questionnaire (EPQ) were rated for most of the patients. Results: Of these MDD inpatients, 20.14% had attempted suicide during the past 1 month. Compared to those who had not attempted suicide, the suicide attempters had a significantly longer duration of illness, lower lowdensity lipoprotein (LDL) cholesterol, lower total cholesterol, and more psychotic symptoms. However, all these significant results did not survive after the bonferroni correction (all p > 0.05). A logistic regression analysis indicated that suicide attempts were associated with the lower total cholesterol and more psychotic symptoms. Conclusions: Our findings support the hypothesis of the association of low plasma cholesterol level and recent suicidal attempts in patients with MDD.

Are Lipids Possible Markers of Suicide Behaviors?

“…In a study of 288 patients conducted by Ma et al [ 47 ], 20.14% had attempted suicide in the previous month. The authors found lower total cholesterol, and more symptoms of psychosis.…”

“…Among others, Ma et al found a correlation between lower LDL-c and more psychotic symptoms showed [ 47 ].…”

“…Many researchers [ 6 , 18 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ] have attempted to identify biological markers that could be linked to suicidal behavior and potentially be used as additional preventive factors. Some of them tried to find the link between cytokines, such as TNF-α, IL-1β, and IL-6 and suicide [ 59 , 60 ]; others measured plasma phospholipid levels of arachidonic acid (AA%), docosahexaenoic acid (DHA%) and eicosapentaenoic acid (EPA%) [ 61 ].…”

“…Levels of thyroid thyroxine (T4), triiodothyronine (T3), thyroid-stimulating hormone (TSH), prolactin, and cortisol were also measured [ 51 ]. Other researchers [ 6 , 18 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ] have focused on the correlation between plasma or serum lipid levels and suicide but, unfortunately, inconsistent results have been reported. Both an increase and a decrease in lipid levels were observed.…”

Association between serum lipid concentrations and attempted suicide in patients with major depressive disorder: A meta-analysis

“…Thirty-one studies [ 3 , 7 , 9 , 10 , 13 , 15 , 17 – 21 , 31 – 44 ], comprising a total of 6,775 patients with MDD, provided data on the serum TC concentrations of suicide attempters (2,560) and non-attempters (4,227) with MDD. The serum TC concentrations of suicide attempters with MDD were significantly lower than those of non-attempters (SMD: -0.63, 95% CI: -0.83 to -0.44, p < 0.001) ( Fig 2 , Table 2 ).…”