Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-23T11:23:07.489Z Has data issue: false hasContentIssue false
  • English
  • Français

The dexamethasone suppression test and CSF-5-HIAA in relation to suicidality and depression in suicide attempters

Published online by Cambridge University Press:  16 April 2020

Åsa Westrin  and
Anders Niméus
Åsa Westrin*
Affiliation:
Department of Clinical Neuroscience, Division of Psychiatry, Lund University, 221 85Lund, Sweden
Anders Niméus
Affiliation:
Department of Clinical Neuroscience, Division of Psychiatry, Lund University, 221 85Lund, Sweden
*
*E-mail address: [email protected]
Get access

Abstract

This study tested suicidality in relation to cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) and the dexamethasone suppression test. Patients with nonsuppression of cortisol had the highest scores of the Suicide Assessment Scale (SUAS) and the Montgomery Asberg Depression Rating Scale (MADRS), respectively (P < 0.05; P < 0.01). The results persisted when analysed for covariance with CSF-5-HIAA. We have previously noted an elevated suicide risk in suicide attempters with high SUAS-scores, why a large part of nonsuppressors may be at high risk for future suicide.

Keywords

Depressive disorderSuicide, attemptedPituitary-adrenal systemSerotoninSuicide Assessment Scale
Type
Original article
Information
European Psychiatry , Volume 18 , Issue 4 , June 2003 , pp. 166 - 171
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed., revised. Washington (DC): American Psychiatric Association; 1987.Google Scholar
Banki, CM, Arato, M, Papp, Z, Kurcz, M. Biochemical markers in suicidal patients. Investigations with cerebrospinal fluid amine metabolites and neuroendocrine tests. J Affective Disorders 1984;6(3-4):341–50.CrossRefGoogle ScholarPubMed
Berger, M, Pirke, KM, Doerr, P, Krieg, JC, Von Zerssen, D. The limited utility of the dexamethasone suppression test for the diagnostic process in psychiatry. Br J Psychiatry 1984;145:372–82.CrossRefGoogle Scholar
Brown, RP, Mason, B, Stoll, P, Kocsis, J, Stokes, PE, et al. Adrenocortical function and suicidal behavior in depressive disorders. Psychiatry Res 1986;17:317–23.CrossRefGoogle ScholarPubMed
Bunney, WE Jr, Fawcett, J. Possibility of a biochemical test for suicidal patients. Arch Gen Psychiatry 1965;13:232–9.CrossRefGoogle Scholar
Bunney, WE Jr, Fawcett, JA, Davis, JM, Giffford, S. Further evaluation of urinary 17- hydroxycorticoids in suicidal patients. Arch Gen Psychiatry 1969;21(2):138–50 (hydroxycorticosteroids in suicidal pa).CrossRefGoogle ScholarPubMed
Bäckman, J, Alling, C, Alsén, M, Regnéll, G, Träskman-Bendz, L. Changes of cerebrospinal fluid monoamine metabolites during long-term antidepressant treatment. Eur Neuropsychopharmacol 2000;10: 341–9.CrossRefGoogle ScholarPubMed
Carroll, BJ, Feinberg, M, Greden, JF, Tarika, J, Albala, AA, Haskett, RF, et al. A specific laboratory test for the diagnosis of melancholia. Standardization, validation and clinical utility. Arch Gen Psychiatry 1981;38(1):15–22.Google Scholar
Coryell, W, Schlesser, MA. Suicide and the dexamethasone suppression test in unipolar depression. Am J Psychiatry 1981;138(8): 1120–1.Google ScholarPubMed
Coryell, W, Schlesser, M. The dexamethasone suppression test and suicide prediction. Am J Psychiatry 2001(5):748–53 158.Google Scholar
Gjerris, A, Werdelin, L, Gjerris, F, Sörensen, PS, Rafaelsen, OJ, Alling, C. CSF-amine metabolites in depression, dementia and controls. Acta Psychiatr Scand 1987;75:619–28.CrossRefGoogle Scholar
Jones, JS, Stein, DJ, Stanley, B, Guido, JR, Winchel, R, Stanley, M. Negative and depressive symptoms in suicidal schizophrenics. Acta Psychiatr Scand 1994;89(2):81–7.CrossRefGoogle ScholarPubMed
Lester, D. The concentration of neurotransmitter metabolites in the cerebrospinal fluid of suicidal individuals: a meta-analysis. Pharmacopsychiatry 1995;28(2):45–50 77-9.Google ScholarPubMed
Lester, D. The dexamethasone suppression test as an indicator of suicide: a meta-analysis. Pharmacopsychiatry 1992;25:226–7.Google ScholarPubMed
Lopez, JF, Akil, H, Watson, J. Neural circuits mediating stress. Biol Psychiatry 1999;46:1461–71.CrossRefGoogle ScholarPubMed
Lopez, JF, Chalmers, DT, Little, KY, Watson, SJ. A.E. Bennett Research Award. Regulation of serotonin 1A, glucocorticoid, and mineralocorticoid receptor in rat and human hippocampus: implications for the neurobiology. Biol Psychiatry 1998;43(8):547–73.CrossRefGoogle ScholarPubMed
Montgomery, SA, Åsberg, M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134:382–9.Google ScholarPubMed
Niméus, A, Alsén, M, Träskman-Bendz, L. The Suicide Assessment Scale—an instrument assessing suicide risk of suicide attempters. Eur Psychiatry 2000;15:416–23.CrossRefGoogle ScholarPubMed
Nordström, P, Samuelsson, M, Åsberg, M, Träskman-Bendz, L, Åberg-Wistedt, A, Nordin, C, et al. CSF 5-HIAA predicts suicide risk after attempted suicide. Suicide Life-Threatening Behav 1994;24(1):1–9.Google ScholarPubMed
Ostroff, R, Giller, E, Bonese, K, Ebersole, E, Harkness, L. Neuroendocrine risk factors of suicidal behavior. 10. Am J Psychiatry 1982;139:1323–5.Google Scholar
Pitchot, W, Hansenne, M, Gonzalez Moreno, A, Ansseau, M. The dex-amethasone suppression test in violent suicide attempters with major depression. Biol Psychiatry 1995;37(4):273–4.Google Scholar
Roy, A. Hypothalamic–pituitary–adrenal axis function and suicidal behavior in depression. Biol Psychiatry 1992;32(9):812–6.CrossRefGoogle ScholarPubMed
Roy, A, De Jong, J, Linnoila, M. Cerebrospinal fluid monoamine metabolites and suicidal behavior n depressed patients. A 5-year follow-up study. Arch Gen Psychiatry 1989;46(7):609–12.CrossRefGoogle Scholar
Schmidtke, A, Fleckenstein, P, Beckmann, H. The dexamethasone suppression test and suicide attempts. Acta Psychiatr Scand 1989;79(3):276–82.CrossRefGoogle ScholarPubMed
Secunda, SK, Cross, CK, Koslow, S, Katz, MM, Kocsis, J, Maas, JW, et al. Biochemistry and suicidal behavior in depressed patients. Biol Psychiatry 1986;21(8-9):756–67.CrossRefGoogle ScholarPubMed
Stanley, B, Träskman-Bendz, L, Stanley, M. The Suicide Assessment Scale: a scale evaluating change in suicidal behavior. Psychopharm Bull 1986;1:200–5.Google Scholar
Targum, SD, Rosén, L, Capodanno, AE. The dexamethasone suppression test in suicidal patients with unipolar depression. Am J Psychiatry 1983;140(7):877–9.Google ScholarPubMed
Traskman, L, Asberg, M, Bertilsson, L, Cronholm, B, Mellstrom, B, Neckers, LM, et al. Plasma levels of chlorimipramine and its demethyl metabolite during treatment of depression. Clin Pharmacol Ther 1979;26(5):600–10.CrossRefGoogle ScholarPubMed
Träskman, L, Åsberg, M, Bertilsson, L, Sjöstrand, L. Monoamine metabolites in CSF and suicidal behavior. Arch Gen Psychiatry 1981;38:631–6.CrossRefGoogle ScholarPubMed
Träskman-Bendz, L, Alling, C, Oreland, L, Regnéll, G, Vinge, E, Öhman, R. Prediction of suicidal behavior from biologic tests. J Clin Psychopharmacol 1992;12(Suppl 2):S21–26.Google ScholarPubMed
van Praag, HM. Faulty cortisol/serotonin interplay. Psychopathological and biological characterization of a new, hypothetical depression subtype (seCa-depression). Psychiatry Res 1996;65:143–57.Google Scholar
Westrin, Å, Ekman, R, Träskman-Bendz, L. High delta sleep-inducing peptide-like immunoreactivity in plasma in suicidal patients with major depressive disorder. Biol Psychiatry 1998;43(10):734–9.CrossRefGoogle ScholarPubMed
Ågren, H, Niklasson, F. Suicidal potential in depression: focus on CSF monoamine purine metabolites. Psychopharm Bull 1986;22(3):656–60.Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.