Prolactin and thyroid hormone levels are associated with suicide attempts in psychiatric patients

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Abstract

The aim of this study is to evaluate biological factors associated with recent suicidal attempts in a naturalistic sample. 

A total of 439 patients suffering from major depression disorder (MDD), bipolar disorder (BD) and psychotic disorders (schizophrenia, schizoaffective disorder and psychosis not otherwise specified), who were consecutively assessed in the Emergency Department of an Italian Hospital (January 2008–December 2009), were included. 

In the whole sample, suicide attempters and non-attempters differed with regard to free triiodothyronine (FT3) and prolactin values only. 

A univariate general linear model indicated significant effects of sex (F_1;379=9.29; P=0.002), suicidal status (F_1;379=4.49; P=0.04) and the interaction between sex and suicidal status (F_1;379=5.17; P=0.02) on prolactin levels. 

A multinomial logistic regression model indicated that suicidal attempters were 2.27 times (odds ratio (OR)=0.44; 95% confidence interval (95%CI): 0.23/0.82; P=0.01) less likely to have higher FT3 values than non-attempters; while prolactin values failed to reach statistical significance (OR=0.99; 95%CI: 0.98/1.00; P=0.051). 

Both prolactin and thyroid hormones may be involved in a complex compensatory mechanism to correct reduced central serotonin activity. 

Further studies may help in understanding how these findings can be used by clinicians in assessing suicide risk.

Abbreviations

• HPT, hypothalamic–pituitary–thyroid;
• TSH, thyroid stimulating hormone;
• TRH, thyrotropin-releasing hormone;
• PRL, prolactin;
• d-FEN, d-fenfluramine test;
• 5-HT, 5-hydroxytryptamine;
• HPA, hypothalamic–pituitary–adrenal;
• ED, Emergency Department;
• DSM-IV TR, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision;
• MDD, major depression disorder;
• BD, bipolar disorder;
• MINI, Mini International Neuropsychiatric Interview;
• DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, third edition, revised;
• SIDP-IV, Structured Interview for DSM-IV Personality;
• AST, aspartate transaminase;
• ALT, alanine transaminase;
• BUN, blood urea nitrogen;
• GGT, gamma-glutamyltransferase;
• FT3, free triiodothyronine;
• FT4, free thyroxine;
• CLIA, chemiluminescent immunoassay;
• BIC, Schwarz’s Bayesian information criterion;
• OR, odds ratio;
• CI, confidence interval.

Keywords

• Attempted suicide;
• Biological predictors;
• Mood disorder;
• Thyroid hormones;
• Depression

Authors

• Maurizio Pompili^{a, b, ,} ,
• Sara Gibiino^c,
• Marco Innamorati^a,
• Gianluca Serafini^a,
• Antonio Del Casale^a,
• Luisa De Risio^a,
• Mario Palermo^a,
• Franco Montebovi^a,
• Sandra Campi^a,
• Vincenzo De Luca^d,
• Leo Sher^e,
• Roberto Tatarelli^a,
• Massimo Biondi^g,
• Fabrice Duval^f,
• Alessandro Serretti^c,
• Paolo Girardi^a

• ^a Department of Neurosciences, Mental Health and Sensory Organs – Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
• ^b McLean Hospital – Harvard Medical School, Boston, MA – USA
• ^c Institute of Psychiatry, University of Bologna, Bologna, Italy
• ^d CAMH, Department of Psychiatry, University of Toronto, Toronto, Canada
• ^e Mount Sinai School of Medicine and James J. Peters Veterans' Administration Medical Center, New York, USA
• ^f Centre Hospitalier, Rouffach, France
• ^g Department of Psychiatry and Psychological Medicine, Sapienza Università di Roma, Rome, Italy

• http://dx.doi.org/10.1016/j.psychres.2012.05.010

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Corresponding author at: Department of Neuroscience, Mental Health and Sensory Organs, Via Grottarossa 1035–1039, 00189 Rome, Italy. Tel.: +39 0633775675; fax: +39 0633775342.

 

Fuente:  Psychiatry Research