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Cited by 65Suicide and Self-Harm StudiesTryptophan and brain disordersStress Responses and Cortisol

The relationships of current suicidal ideation with inflammatory markers and heart rate variability in unmedicated patients with major depressive disorder

Chang, Chuan-Chia, Tzeng, Nian-Sheng, Kao, Yu-Chen, Yeh, Chin-Bin, Chang, Hsin-An·2017·Psychiatry Research
DOI 10.1016/j.psychres.2017.08.076
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Abstract

Studies investigating inflammatory status and autonomic functioning simultaneously in depressed patients with current suicidal ideation (SI) are lacking. We recruited 58 unmedicated depressed patients with current SI but without lifetime history of suicidal behavior, as well as 61 equally depressed patients without lifetime history of SI or suicidal behavior. We measured serum cortisol, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and autonomic functioning evaluated by frequency-domain measures of heart rate variability (HRV). The intensity of current SI was rated with the Columbia Suicide Severity Rating Scale. Chronic psychological stress was assessed using the Chinese version of the Perceived Stress Scale (PSS). Patients with current SI showed higher hs-CRP and ESR but lower variance (total HRV), low frequency (LF), and high frequency (HF) HRV than those without lifetime history of SI. We found no differences in cortisol levels and PSS scores. The intensity of current SI was negatively correlated with variance, LF, and HF but positively correlated with hs-CRP. Our results help improve the understanding of the relationships among current SI, inflammation, and autonomic functioning in depressed patients. The combined use of inflammatory markers and HRV indices may one day be applied in predicting and monitoring patients' suicide risk.

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  • Greater suicidal ideation severity is associated with higher CRP, IL-6, and IL-10 levels and with activated microglia-related alterations of the tryptophan-kynurenine pathway.

    “Greater suicidal ideation severity is associated with higher CRP (197), IL-6, and IL-10 levels (215) and with activated microglia-related alterations of the tryptophan-kynurenine pathway (216).”

    From A brain-centric model of suicidal behavior (2020) · cites this paper as [197]

  • Peripheral inflammatory biomarkers linked to suicide risk include elevated CRP, neutrophil-to-lymphocyte ratio, proinflammatory interleukins, cytokines such as IL-1β and IL-6, TNF-α, TGF-β1, and VEGF, and low levels of anti-inflammatory IL-2, IL-4, and IFN-γ in suicidal individuals.

    “Peripheral inflammatory biomarkers linked to suicide risk include elevated C-reactive protein (CRP), neutrophil-to-lymphocyte ratio, proinflammatory interleukins (IL), cytokines that regulate the immune response (e.g., IL-1β and IL-6), tumor necrosis factor-α (TNF-α), tissue growth factor-β1 (TGF-β1), and vascular endothelial growth factor (VEGF) and low levels of the anti-inflammatory IL-2, IL-4,”

    From A brain-centric model of suicidal behavior (2020) · cites this paper as [197]

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Authors
Chang, C.-C., Tzeng, N.-S., Kao, Y.-C., Yeh, C.-B., & Chang, H.-A.
Affiliations
Tri-Service General Hospital (TW)
Corresponding author
Chang, Hsin-An
ORCID
Venue
Psychiatry Research
Publisher
Elsevier BV
Published
2017-12
Volume
258
Pages
449-456
ISSN
0165-1781 (ISSN-L)
DOI
10.1016/j.psychres.2017.08.076
OpenAlex
W2752206110
Cited by
65
References
86
Citations by year
2026: 7 · 2025: 9 · 2024: 5 · 2023: 7 · 2022: 9 · 2021: 7 · 2020: 12 · 2019: 4 · 2018: 5
FWCI
7.10
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Psychiatry Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Ministry of Science and Technology of the Taiwanese Government (MOST-103-2314-B-016-021)
  • Tri-Service General Hospital (TSGH-C105-121)
  • National Defense Medical Research (MAB-104-008)
  • Teh-Tzer Study Group for Human Medical Research Foundation (A1011070, A1021012, A1031056)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
suicidal ideation, major depressive disorder, inflammatory markers, heart rate variability, C-reactive protein, erythrocyte sedimentation rate, cortisol, autonomic nervous system, psychological stress, suicide risk prediction, untreated depression
MeSH terms
Adult, C-Reactive Protein, Depression, Major Depressive Disorder, Female, Heart Rate, Humans, Hydrocortisone, Inflammation, Male, Middle Aged, Stress, Psychological, Biomarkers, Young Adult, Suicidal Ideation

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