HPA axis hyperactivity and attempted suicide in young adult mood disorder inpatients
Abstract
Background Hyperactivity of the Hypothalamic-Pituitary-Adrenal (HPA) axis is a consistent finding in Major Depressive Disorder (MDD) and most prospective studies of HPA-axis function have found that non-suppressors in the dexamethasone suppression test (DST) are more likely to commit suicide during follow-up. The results of studies on HPA-axis function and attempted suicide are less consistent. Suicide attempts are more common among young people than the elderly, whereas suicide is more common among the elderly. The impact of age related changes in HPA-axis system activity in relation to suicidal behaviour across the lifecycle may be of importance.Methods The aim of the present study was to investigate the DST results in 36 young adult (30 years or younger) inpatients with mood disorder, with (n=18) and without suicide attempt at the index episode.Results The DST non-suppressor rate was 25% among young mood disorder inpatients. DST non-suppression was associated with suicide attempt and post-dexamethasone serum cortisol at 11:00 p.m. was significantly higher in suicide attempters compared to non-attempters. The DST non-suppressor rate was 39% in young adult suicide attempters compared with 11% in non-attempters.Conclusions The results add to previous evidence in support of the role of HPA axis hyperactivity and suicidal behaviour. The present findings motivate to include HPA axis measures in the assessment of depression in young adults.
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Nonsuppression on the dexamethasone suppression test predicts suicide, but there is disagreement about nonfatal attempts.
“Nonsuppression on the dexamethasone suppression test, which assesses this HPA axis glucocorticoid receptor feedback loop, predicts suicide (151-153), but there is disagreement about nonfatal attempts (154-158).”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [155]
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- Authors
- Jokinen, J., & Nordström, P.
- Affiliations
- Karolinska University Hospital (SE)
- Corresponding author
- Jokinen, Jussi
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2009-07
- Volume
- 116
- Issue
- 1-2
- Pages
- 117-120
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2145892469
- Cited by
- 143
- References
- 39
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 11 · 2020: 10 · 2019: 8 · 2018: 26 · 2017: 8 · 2016: 10 · 2015: 8 · 2014: 8 · 2013: 9 · 2012: 6
- FWCI
- 3.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Department of Science and Technology, Ministry of Science and Technology, India
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- HPA axis hyperactivity, suicide attempts, major depressive disorder, young adults, dexamethasone suppression test, cortisol, mood disorders, depression assessment
- MeSH terms
- Adult, Age Factors, Dexamethasone, Female, Glucocorticoids, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Inpatients, Male, Pituitary-Adrenal System, Predictive Value of Tests, Suicide, Attempted, Mood Disorders, Young Adult
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