Epigenetic changes in the CRH gene are related to severity of suicide attempt and a general psychiatric risk score in adolescents
Open accessAbstract
The aim of this study, comprising 88 suicide attempters, was to identify hypothalamic-pituitary-adrenal (HPA) -axis coupled CpG-sites showing methylation shifts linked to severity of the suicide attempt. Candidate methylation loci were further investigated as risk loci for a general psychiatric risk score in two cohorts of adolescents (cohort 1 and 2). The genome-wide methylation pattern was measured in whole blood using the Illumina Infinium Methylation EPIC BeadChip. Subjects were stratified into high-risk and low-risk groups based on the severity of the suicidal behavior. We included CpG sites located within 2000 basepairs away from transcriptional start site of the following HPA-axis coupled genes: corticotropin releasing hormone (CRH), corticotropin releasing hormone binding protein (CRHBP), corticotropin releasing hormone receptor 1 (CRHR1), corticotropin releasing hormone receptor 2 (CRHR2), FK506-binding protein 51 (FKBP5) and the glucocorticoid receptor (NR3C1). The methylation state of two corticotropin releasing hormone (CRH)-associated CpG sites were significantly hypomethylated in the high-risk group of suicide attempters (n=31) (cg19035496 and cg23409074) (p<0.001). Adolescent cohort 1 and 2 consisted of 129 and 93 subjects, respectively, and were stratified by the in silico generated DAWBA measurements of a general psychiatric risk score into high-risk group (>~50% risk) or controls. In adolescent cohort 2, cg19035496 was hypermethylated in subjects with a high general psychiatric risk score. Our results show epigenetic changes in the CRH gene related to severity of suicide attempt in adults and a general psychiatric risk score in adolescents.
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Cortisol regulation and stress-related DNA methylation differ in direction between pediatric and adult cohorts.
“Different markers, most notably cortisol regulation and stress-related DNA methylation, differed in direction between pediatric and adult cohorts, indicating that adult biomarker data cannot be directly extrapolated to youth.”
From Exploring the neurobiological markers of suicidal behaviors in pediatric population: a narrative review (2026) · cites this paper as [58]
The Discussion reports that a CRH CpG site was hypermethylated in adolescents at high psychiatric risk but hypomethylated in adult severe suicide attempters, and cautions against direct comparison of the cohorts. The paper does not report an opposite direction of cortisol regulation between pediatric and adult cohorts; its Introduction discusses cortisol findings without making that comparison. Page numbers are not available in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredJokinen et al. identified two CRH promoter CpG sites (cg19035496 and cg23409074) that were hypomethylated in adults with violent suicide attempts but hypermethylated in high-risk adolescents, suggesting age-dependent differences in stress regulation.
“Jokinen et al. identified two CRH promoter CpG sites (cg19035496 and cg23409074) that were hypomethylated in adults with violent suicide attempts but hypermethylated in high-risk adolescents, suggesting age-dependent differences in stress regulation (58).”
From Exploring the neurobiological markers of suicidal behaviors in pediatric population: a narrative review (2026) · cites this paper as [58]
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Experimental — accuracy not yet measuredMethylation alterations in CRH, SKA2, BDNF, and SLC6A4 have also been implicated in suicidal behavior.
“Methylation alterations in corticotropin-releasing hormone (CRH), spindle and kinetochore-associated complex subunit 2 (SKA2), brain-derived neurotrophic factor (BDNF), and SLC6A4 have also been implicated in suicidal behavior.”
From Exploring the neurobiological markers of suicidal behaviors in pediatric population: a narrative review (2026) · cites this paper as [58]
The Results section reports reduced CRH promoter methylation in people with more severe suicide attempts, supporting the CRH portion. The copy does not substantiate methylation alterations in SKA2, BDNF, or SLC6A4 as implicated in suicidal behavior; its References section mentions SKA2 expression, not methylation. No page numbers are available in the indexed passages. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe direction of stress-related methylation, not merely its magnitude, is age-dependent.
“indicating that the direction of stress-related methylation, not merely its magnitude, is age-dependent.”
From Exploring the neurobiological markers of suicidal behaviors in pediatric population: a narrative review (2026) · cites this paper as [58]
The Discussion reports opposite directions at one CRH methylation site: hypermethylation in adolescents at high psychiatric risk and hypomethylation in adults with severe suicide attempts. It cautions that directly comparing the cohorts is difficult. Because the groups differed in psychiatric outcome as well as age, the paper does not establish that age determines the direction of stress-related methylation. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOne CRH promoter CpG site (cg19035496) was hypomethylated in adults with violent suicide attempts but hypermethylated in adolescents at high psychiatric risk.
“Jokinen et al. found that one CRH promoter CpG site (cg19035496) was hypomethylated in adults with violent suicide attempts but hypermethylated in adolescents at high psychiatric risk (58), indicating that the direction of stress-related methylation, not merely its magnitude, is age-dependent.”
From Exploring the neurobiological markers of suicidal behaviors in pediatric population: a narrative review (2026) · cites this paper as [58]
The Results report that CRH promoter site cg19035496 was hypomethylated in the adult high-risk/severe-attempt group, while the Discussion reports hypermethylation at that site in adolescents at high psychiatric risk. However, the Methods define the adult group using a violent attempt, a high severity-scale score, or later completed suicide; the finding is not reported specifically for adults with violent attempts. (LLM, conf=0.87)
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References 62 · Cited by 67
Research works printed but not linked: 1
- Sambrook J. Fritsch E.F. Maniatis T. Molecular Cloning A Laboratory Manual Second Edition Vol. 1,2,3 1989 Cold Spring Harbor Lab Press
- Authors
- Jokinen, J., Boström, A. E., Dadfar, A., Ciuculete, D. M., Chatzittofis, A., Åsberg, M., & Schiöth, H. B.
- Affiliations
- Karolinska Institutet (SE)
- Uppsala University (SE)
- Umeå University (SE)
- Corresponding author
- Jokinen, Jussi
- ORCID
- Venue
- EBioMedicine
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 27
- Pages
- 123-133
- ISSN
- 2352-3964 (ISSN-L)
- PMC
- PMC5828554
- OpenAlex
- W2780464634
- Cited by
- 67
- References
- 62
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 7 · 2023: 13 · 2022: 9 · 2021: 8 · 2020: 13 · 2019: 1 · 2018: 5 · 2015: 1
- FWCI
- 6.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- EBioMedicine (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Vetenskapsrådet (K2009-61P-21304-04-4, K2009-61X-21305-01-1)
- European Regional Development Fund
- Knut och Alice Wallenbergs Stiftelse
- Umeå Universitet
- Västerbotten Läns Landsting (VLL-582221)
- Australian Liver Foundation (SLL-20150269)
- Stockholms Läns Landsting
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Epigenetics and DNA Methylation
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- DNA methylation, suicide attempts, hypothalamic-pituitary-adrenal axis, adolescents, FKBP5, glucocorticoid receptor, CRH receptors, CRH-binding protein, suicide risk
- MeSH terms
- Adolescent, Adult, Aged, Behavior, Brain, Corticotropin-Releasing Hormone, Female, Humans, Hypothalamo-Hypophyseal System, Male, Middle Aged, Pituitary-Adrenal System, Risk Factors, Suicide, Attempted, Transcription, Genetic, Cohort Studies, Logistic Models, CpG Islands, DNA Methylation, Epigenesis, Genetic, Young Adult
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