ArticlePsychoneuroendocrinology2017
Blunted HPA axis activity prior to suicide attempt and increased inflammation in attempters.
Article in Psychoneuroendocrinology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 5 of them syntheses that pooled it.
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Who cites it
65 citing papers in PubMed, 5 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Pooled it
- Inflammation and nitro-oxidative stress in current suicidal attempts and current suicidal ideation: a systematic review and meta-analysis.Molecular psychiatry · 2022Pooled it
- Pooled it
- A Specific Inflammatory Profile Underlying Suicide Risk? Systematic Review of the Main Literature Findings.International journal of environmental research and public health · 2020Pooled it
- The association between adversity and hair cortisol levels in humans: A meta-analysis.Psychoneuroendocrinology · 2019Pooled it
- Stress-related salivary biomarkers - cortisol, dehydroepiandrosterone, alpha amylase, and suicidal ideation among young women living in Kampala's informal settlements.Social psychiatry and psychiatric epidemiology · 2026Article
- Distinct effects of current suicidal symptoms and lifetime suicide attempts on C-reactive protein levels and executive function in young people with major affective disorders.European archives of psychiatry and clinical neuroscience · 2026Article
- Hair cortisol concentrations as a putative biomarker for suicidal behavior.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Biological Risk Factors for Suicidal Behavior in Children and Adolescents: A Narrative Review.Children (Basel, Switzerland) · 2026Review
- Hair stress hormones in individuals with a recent suicide attempt experiencing a depressive episode.Neurobiology of stress · 2026Article
- Review
- Epigenetics and immunology: Under-recognized aspects of suicidality.World journal of psychiatry · 2025Review
- Childhood trauma cortisol and immune cell glucocorticoid transcript levels are associated with increased risk for suicidality in adolescence.Molecular psychiatry · 2025Article
- Association of sleep problems with suicidal behaviors and healthcare utilization in adults with chronic diseases: the role of mental illness.Annals of general psychiatry · 2025Article
- Peripheral biological correlates of suicidality in children and adolescents: A systematic review and meta-analysis.iScience · 2025Article
- Do Cortisol Levels Play a Role in Suicidal Behaviors and Non-Suicidal Self-Injuries in Children and Adolescents?-A Narrative Review.Brain sciences · 2025Review
- Correlation Between Systemic Immune Inflammatory Index and Suicidal Attempt in Patients with First-Episode Untreated Depression and its Risk Factors.Neuropsychiatric disease and treatment · 2025Article
- Influences of sleep, cortisol reactivity, and risk/reward-based decision-making on suicide.Journal of behavior therapy and experimental psychiatry · 2024Article
- Proinflammatory cytokine levels, cognitive function, and suicidal symptoms of adolescents and young adults with major depressive disorder.European archives of psychiatry and clinical neuroscience · 2024Article
- Higher levels of plasma Adrenocorticotropic hormone (ACTH) are associated with lower suicidal ideation in depressed patients compared to controls and suicide attempters, independently from depression severity.Comprehensive psychoneuroendocrinology · 2024Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundHypothalamic-Pituitary-Adrenal (HPA) axis dysregulation is associated with increased risk for suicidal behavior. However, it is not clear whether such dysregulation exists prior to or is a consequence of attempt. Studies also show an activation of inflammatory responses in suicidal behavior but often combine attempters with those with ideation.
methodsThe sample consisted of psychiatric inpatients, aged 15-30 years, admitted for suicide attempt (SA, n=38), inpatients admitted for suicidal ideation with no prior history of attempts (SI, n=40), and healthy controls (n=37). We compared SA, SI, and controls on hair cortisol concentrations (HCC), which provides retrospective levels of cortisol and thus prior to the attempt in SA. We also compared them on the expression of genes in the HPA axis and inflammatory pathways previously implicated in suicidal behavior (GR or NR3C1, SKA2, FKBP5, IL-1β, TNF-α); plasma C-Reactive Protein (CRP); and cellular measures of glucocorticoid receptor (GR) sensitivity and stimulated production of IL-6.
resultsWe found lower HCC [β=-0.55, 95% CI (-0.96, -0.13), p=0.01, ES=-0.54] in first-time SA compared to SI and controls. In addition, SA showed lower GR or NR3C1 (α isoform) mRNA [β=-5.11, 95% CI (-10.9, 0.73), p=0.09, ES=-0.46], higher CRP [β=0.94, 95% CI (-0.004, 1.9), p=0.05, ES=0.60], and higher TNF-α mRNA [β=26.4, 95% CI (7.7, 45.2), p=0.006, ES=0.73].
conclusionsThis is the first study to differentiate youth who attempt suicide from those with suicidal ideation on HCC and to show that low HCC precedes suicide attempt. Suicide attempters also showed a distinct biological profile on several markers in both the HPA axis and inflammatory pathways. Future longitudinal studies are needed to examine the ability of these biomarkers to predict suicidal behavior.
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Registered trials
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