CSF 5-HIAA, cortisol and DHEAS levels in suicide attempters
Abstract
The serotonin system and the hypothalamic-pituitary-adrenal (HPA) axis are involved in the biological vulnerability to suicidal behaviour. Altered levels of dehydroepiandrosterone (DHEA) and its sulphate ester DHEAS have been reported in neuropsychiatric conditions. The aim of this study was to investigate CSF levels of 5-Hydroxyindoleacetic acid (5-HIAA) and CSF and plasma levels of cortisol and DHEAS in 28 medication free suicide attempters and 19 healthy volunteers. Another aim was to investigate the relationship between neuroendocrine measures and childhood trauma in suicide attempters. As the study design includes a longitudinal part, we investigated whether CSF cortisol, 5-HIAA or DHEAS would predict subsequent suicide. We hypothesized higher cortisol levels in suicide attempters and lower CSF 5-HIAA levels and higher cortisol levels in suicide victims. Suicide attempters had higher CSF and plasma cortisol levels compared to healthy volunteers. Male suicide attempters had higher CSF DHEAS levels and female suicide attempters had lower CSF 5-HIAA levels compared to male and female healthy volunteers respectively. Exposure to interpersonal violence as a child showed a negative correlation with CSF cortisol/DHEAS ratio adjusted for age, gender and depression severity in a regression analysis. Suicide victims tended to have low CSF 5-HIAA and high CSF cortisol. Abused suicide victims had higher CSF cortisol compared to suicide victims with low exposure to interpersonal violence as a child. The results underlie the important role of the serotonergic system and HPA axis in suicidal behaviour and suggest that CSF DHEAS may be elevated in male suicide attempters.
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Suicide victims exposed to interpersonal violence as children exhibit elevated CSF cortisol among suicide attempters.
“suicide victims exposed to interpersonal violence as children exhibit elevated CSF cortisol among suicide attempters (Chatzittofis et al., 2013).”
From Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease (2017) · cites this paper as Chatzittofis et al., 2013
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- Authors
- Chatzittofis, A., Nordström, P., Hellström, C., Arver, S., Åsberg, M., & Jokinen, J.
- Affiliations
- Karolinska University Hospital (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Jokinen, Jussi
- Venue
- European Neuropsychopharmacology
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 23
- Issue
- 10
- Pages
- 1280-1287
- ISSN
- 0924-977X (ISSN-L)
- OpenAlex
- W2040366893
- Cited by
- 84
- References
- 41
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 8 · 2019: 6 · 2018: 6 · 2017: 8 · 2016: 15 · 2015: 6 · 2014: 6 · 2013: 1
- FWCI
- 10.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- suicide attempters, 5-hydroxyindoleacetic acid, cortisol, dehydroepiandrosterone, dehydroepiandrosterone sulfate, cerebrospinal fluid biomarkers, hypothalamic-pituitary-adrenal axis, serotonergic system, childhood trauma, interpersonal violence, suicide risk prediction, sex differences
- MeSH terms
- Adult, Aged, Depression, Female, Humans, Hydrocortisone, Hydroxyindoleacetic Acid, Longitudinal Studies, Male, Middle Aged, Severity of Illness Index, Sex Characteristics, Stress, Physiological, Stress, Psychological, Suicide, Suicide, Attempted, Sweden, Violence, Down-Regulation, Up-Regulation, Self-Injurious Behavior, Dehydroepiandrosterone Sulfate, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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