Cited by 25Suicide and Self-Harm StudiesStress Responses and CortisolHomicide, Infanticide, and Child Abuse

The role of peripheral cortisol levels in suicide behavior: a systematic review and meta-analysis of 30 studies

Hernández-Díaz, Yazmin, González-Castro, Thelma Beatriz, Tovilla-Zárate, Carlos Alfonso, Juárez-Rojop, Isela Esther, López-Narváez, María Lilia, Pérez-Hernández, Nonanzit, Rodríguez-Pérez, José Manuel, Genis-Mendoza, Alma Delia +1 more·2020·Psychiatry Research

Abstract

Cortisol can be considered as one biomarker for diagnosis of suicide; nevertheless, several studies have shown conflicting results. This study aimed to evaluate the levels of cortisol in individuals with suicide behavior and controls (healthy or with other psychiatric disorders). Published articles were searched on online databases (PubMed, Scopus and EBSCO). Standardized mean differences (SMD), heterogeneity, publication bias and sensitivity were assessed using the Comprehensive Meta-Analysis (CMA) statistical software. The meta-analysis comprised 30 studies that provided 1775 cases, and 2162 controls (696 healthy individuals and 1465 individuals with other psychiatric diagnoses). The pooled results revealed that cortisol levels were higher in individuals with suicide behavior (SMD = 0.92, 95%CI = 0.26; 1.57, P = 0.006; I 2 = 88%, Q < 0.001) than healthy controls. However, individuals with suicide behavior showed decreased levels of cortisol in the morning. Additionally, individuals with suicide behavior showed lower levels of cortisol than psychiatric controls (SMD = -1.79, 95%CI = -3.01; -0.58, P = 0.004, I 2 = 89%, Q < 0.001). Morning cortisol levels in individuals with suicide behavior were higher than morning cortisol levels in psychiatric controls. Our updated meta-analysis suggests that peripheral levels of cortisol have a role in suicide behavior.

Integrity signals

Registry

Crossref · 10.1016/j.psychres.2020.113448

Cites

61 of 61 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • When suicidal individuals were compared to psychiatric controls rather than healthy individuals, cortisol levels were significantly lower.

    “Additionally, when suicidal individuals were compared to psychiatric controls rather than healthy individuals, cortisol levels were significantly lower.”
  • When morning cortisol was examined specifically, levels were lower in suicidal individuals relative to healthy controls.

    “However, when morning cortisol was examined specifically, levels were paradoxically lower in suicidal individuals relative to healthy controls, highlighting the importance of circadian timing in hormonal assessment.”
  • A large meta-analysis including 30 studies with over 1,700 individuals with suicidal behavior and 2,000 controls reported that individuals with suicidal ideation or attempts had higher overall cortisol levels than healthy controls.

    “A large meta-analysis including 30 studies with over 1,700 individuals with suicidal behavior and 2,000 controls reported that individuals with suicidal ideation or attempts had higher overall cortisol levels than healthy controls (89).”

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Hernández-Díaz, Y., González-Castro, T. B., Tovilla-Zárate, C. A., Juárez-Rojop, I. E., López-Narváez, M. L., Pérez-Hernández, N., Rodríguez-Pérez, J. M., Genis-Mendoza, A. D., & Nicolini, H.
Affiliations
National Institute of Genomic Medicine (MX)
Venue
Psychiatry Research
Publisher
Elsevier BV
Published
2020-11
Volume
293
Pages
113448
ISSN
0165-1781 (ISSN-L)
OpenAlex
W3088247078
Cited by
25
References
61
Citations by year
2026: 3 · 2025: 5 · 2024: 4 · 2023: 7 · 2022: 4 · 2021: 2
FWCI
0.26
Type
journal article
Language
en
Open access
closed
Locations
  • Psychiatry Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
cortisol, suicidal behavior, diurnal cortisol rhythm, morning cortisol, mental illness, suicide risk
MeSH terms
Mental Disorders, Humans, Hydrocortisone, Suicide, Suicide, Attempted, Biomarkers, Case-Control Studies, Suicidal Ideation

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review