ArticleFrontiers in psychiatry2020
Dexamethasone Suppression Test May Predict More Severe/Violent Suicidal Behavior.
Article in Frontiers in psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 66 citations in OpenAlex.
- Suicidal ideation associated with daridorexant treatment in insomnia patients: Comparator-restricted disproportionality analysis and assessment of potential heterogeneity in reporting patterns.Social psychiatry and psychiatric epidemiology · 2026Article
- Sociodemographic characteristics of suicide attempters treated in the emergency department and the effect of psychological care.World journal of psychiatry · 2026Article
- Childhood trauma cortisol and immune cell glucocorticoid transcript levels are associated with increased risk for suicidality in adolescence.Molecular psychiatry · 2025Article
- A pharmacological and brain imaging study of human vasopressin AVP1BR receptor functional polymorphisms.BMC neuroscience · 2025Article
- Biological Basis for the Formation of Suicidal Behavior: A Review.Medical journal of the Islamic Republic of Iran · 2025Review
- From Social Stress and Isolation to Autonomic Nervous System Dysregulation in Suicidal Behavior.Current psychiatry reports · 2024Review
- Relationship of stress-reactive cortisol to suicidal intent of prior attempts in major depression.Psychiatry research · 2023Article
- Cortisol and the Dexamethasone Suppression Test as a Biomarker for Melancholic Depression: A Narrative Review.Journal of personalized medicine · 2023Review
- Chronic stress, neuroinflammation, and depression: an overview of pathophysiological mechanisms and emerging anti-inflammatories.Frontiers in psychiatry · 2023Review
- How Does COVID-19 Affect the Neurobiology of Suicide?Current psychiatry reports · 2021Review
- [Suicidal behavior in light of COVID-19 outbreak: Clinical challenges and treatment perspectives].L'Encephale · 2020Review
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSeveral studies demonstrated that the hypothalamic-pituitary-adrenal (HPA) axis is dysregulated in suicide attempters. Prospective studies found that people with an abnormal response at the dexamethasone suppression test (DST) are more likely to commit suicide. However, whether DST may predict suicide attempts remains less clear. A possible strategy to address this question is to consider the suicide attempt lethality.
objectives(1) To compare the pre- and post-DST cortisol levels in serious/violent suicide attempters and in non-serious/non-violent suicide attempters, and (2) to investigate whether cortisol level can predict new suicide attempts or their lethality.
methodsThe study included 70 recent suicide attempters (25 with a serious or violent attempt) who were followed for two years. Three saliva samples for cortisol measurement were obtained at 8a.m., 3p.m., and 9p.m. before the DST (pre-DST). Then, at 11 p.m., 1 mg of dexamethasone was given orally. The following day (post-DST), three saliva samples were collected at the same hours as before. The post-DST-pre-DST salivary cortisol Δ index was calculated for each collection time. The Risk-Rescue Ratio Scale (RRRS) and the Suicidal Intent Scale (SIS) were used to characterize the suicide attempt at inclusion and those occurring during the follow-up.
resultsPost-DST cortisol level at 9 p.m. was higher in patients with an initial violent or serious suicide attempt than in non-violent/non-serious attempters (p < .010). Higher post-DST cortisol at 9p.m. was associated with lower RRRS rescue score and higher clinical impression of suicide severity at inclusion. Among the 66 patients who completed the follow-up, 26 attempted suicide again at least once. Higher pre-DST cortisol at 8a.m. predicted new suicide attempts during the follow-up (OR = 2.15 [1.11, 4.15]), and higher cortisol Δ index at 9p.m. was associated with higher suicide intent during the follow-up.
conclusionsOur results suggest that HPA axis hyper-reactivity monitored with the DST is a marker of violent/serious suicide attempt with lower rescue possibility. Furthermore, higher changes between pre-DST and post-DST cortisol levels may predict higher suicide intent. These findings might help to characterize the biological features of nearest suicide phenotypes.
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