Salivary cortisol and suicidal behavior -: A follow-up study
Salivary cortisol and suicidal behavior -: A follow-up study
复制标题
DOI：
10.1016/j.psyneuen.2008.05.012
复制
发表时间：
2008-09-01
影响因子：
3.7
通讯作者：
Brundin, Lena
中科院分区：
文献类型：
--
作者：
Lindqvist, Daniel;Isaksson, Anders;Brundin, Lena
简介：下丘脑-垂体-肾上腺 (HPA) 轴过度活跃是重度抑郁症的常见表现。针对自杀未遂者的类似研究并不多，而且结果也存在分歧。本研究的主要目的是调查自杀未遂时和随访时的 HPA 轴参数，以寻找 HPA 轴功能与自杀行为之间的关联。方法：1986 年至 1992 年间，35 名自杀未遂者和 16 名非自杀对照者入住精神病房。脑脊液和尿液中的促肾上腺皮质激素释放激素 (CRH)为自杀未遂者获取皮质醇。患者入院后大约 12 年进行了随访。测量唾液中的皮质醇，并记录额外的自杀企图和当前的精神症状。结果：在随访中，与对照组相比，自杀企图者夜间唾液皮质醇较低。随访时皮质醇水平低与严重的精神症状有关。在女性中，反复自杀企图与早晨和午餐唾液皮质醇有关，在该亚组中，我们还发现随访时的唾液皮质醇与 CRH 以及索引时的尿皮质醇之间存在显着相关性。结论：我们发现了两个 HPA 轴活动与自杀行为之间存在关联的证据。这可能是由于长期和严重的精神疾病导致的，这反过来又耗尽了这些患者的 HPA 轴。在自杀患者的研究中应更多地关注皮质醇功能减退症的潜在作用。 (c) 2008 Elsevier Ltd. 保留所有权利。
Introduction: Hyperactivity of the hypothalamic-pituitary-adrenal (HPA)-axis is a common finding in major depressive disorder. Similar studies on suicide attempters are less abundant, and the results are divergent. The main aim of the present study was to investigate HPA-axis parameters by the time of a suicide attempt and at follow-up in search for associations between HPA-axis function and suicidal behavior.Methods: Thirty-five suicide attempters and 16 non-suicidal controls were admitted to a psychiatric ward between the years of 1986 and 1992. Corticotrophin-releasing hormone (CRH) in cerebrospinal fluid and urinary cortisol were obtained for the suicide attempters. The patients were followed up approximately 12 years after the index admission. Cortisol was measured in saliva, and additional suicide attempts and current psychiatric symptoms were registered.Results: At follow-up, evening salivary cortisol was lower in suicide attempters compared to controls. Low cortisol levels at follow-up were associated with severe psychiatric symptoms. Among women, repeated suicide attempts were associated with tow morning and lunch salivary cortisol, and in this subgroup we also found significant correlations between salivary cortisol at follow-up, and CRH as well as urinary cortisol at index.Conclusion: We found evidence for an association between tow HPA-axis activity and suicidal behavior. This could be due to tong-lasting and severe psychiatric morbidity, which in turn has exhausted the HPA-axis of these patients. The potential role of hypocortisolism should be given more attention in studies on suicidal patients. (c) 2008 Elsevier Ltd. All rights reserved.