The DOI matches its Crossref record; 56 of the 56 references it cites were found in a registry or an index.
Can biological tests assist prediction of suicide in mood disorders?
Open accessAbstract
Predicting suicide is difficult due to its low base-rate and the limited specificity of clinical predictors. Prospective biological studies suggest that dysfunctions in the serotonergic system and hypothalamic-pituitary-adrenal axis have some predictive power for completed suicide in mood disorders. A prediction model that incorporates biological testing to increase specificity and sensitivity of prediction of suicide is of potential clinical value. Meta-analyses of prospective biological studies of suicide and cerebrospinal fluid 5-hydroxyindoleacetic acid (CSF 5-HIAA) and suicide and the dexamethasone suppression test (DST) in mood disorders using the penalized quasi-likelihood (PQL) and bootstrap method yield odds ratios for prediction of suicide of 4.48 and 4.65 respectively. Two combinatory prediction models, the first requiring positive results on more than one test, and the second requiring a positive result on either one of two tests, were tested to assess their sensitivity, specificity, and predictive power using biological data from published and unpublished studies. The prediction model that requires both DST and CSF 5-HIAA tests to be positive results in 37.5% sensitivity, 88% specificity, and has a positive predictive value of 23%. The prediction model that requires either DST or CSF 5-HIAA tests to be positive results in 87.5% sensitivity, 28% specificity, and has a positive predictive value of 10%. Thus, models attempting to predict a lethal outcome that is uncommon perform very differently making model choice of major importance. Further work on refining biological predictors and integration with clinical predictors is needed to optimize a model to predict suicide in the clinic.
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“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 [151]
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Cites
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722
An Introduction to the Bootstrap
Efron, B., & Tibshirani, R. J. (1994) · doi:10.1201/9780429246593 · Cited by 40,500
Hapeman, D. E., & Agresti, A. (1991) · Technometrics · doi:10.1080/00401706.1991.10484817 · Cited by 9,407
Fleiss, J. L., & Agresti, A. (1991) · Journal of the American Statistical Association · doi:10.2307/2290537 · Cited by 2,670
Toward a clinical model of suicidal behavior in psychiatric patients
Mann, J. J., Waternaux, C., Haas, G. L., & Malone, K. M. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.2.181 · Cited by 1,791 · cited 2×
“…Coccaro et al., 1989; Placidi et al., 2001; Oquendo and Mann, 2000; Oquendo et al., 2003) studies, have reported associations between serotonergic dysfunction and aggressive and impulsive traits that are thought to be a clinical aspect of the diathesis for suicidal behaviour (Mann et al., 1999).”
BackgroundSelf-citation5-HIAA in the Cerebrospinal Fluid
Åsberg, M. (1976) · Archives of General Psychiatry · doi:10.1001/archpsyc.1976.01770100055005 · Cited by 1,455
Neurobiology of suicidal behaviour
Mann, J. J. (2003) · Nature Reviews Neuroscience · doi:10.1038/nrn1220 · Cited by 1,260
Self-citationAn Introduction to the Bootstrap.
Kimber, A., Efron, B., & Tibshirani, R. J. (1994) · Journal of the Royal Statistical Society Series D (The Statistician) · doi:10.2307/2348146 · Cited by 1,246
Serotonergic Studies in Patients With Affective and Personality Disorders
Coccaro, E. F. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810070013002 · Cited by 1,085
Prediction of Suicide in Psychiatric Patients
Pokorny, A. D. (1983) · Archives of General Psychiatry · doi:10.1001/archpsyc.1983.01790030019002 · Cited by 749
Research works printed but not linked: 3
- Amsel L, Mann JJ (2001). Suicide risk assessment and the suicidal process approach. In: van Heeringen K (Ed.), Understanding Suicidal Behaviour: The Suicidal Process Approach to Research and Treatment (pp. 163-181). Sussex: John Wiley and Sons, Ltd.
- A ˚sberg M, Nordstro ¨m P, Tra ¨skman-Bendz L (1986). Biological factors in suicide. In: Roy A (Ed.), Suicide (pp. 47-71). Baltimore: Williams and Wilkins.
- Stanley M, Mann JJ, Gershon S (1983). Alterations in pre-and postsynaptic serotonergic neurons in suicide victims. Psychopharmacological Bulletin 19, 684-687.
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Sorted by citations
Measuring the Suicidal Mind: Implicit Cognition Predicts Suicidal Behavior
Nock, M. K., Park, J. M., Finn, C. T., Deliberto, T. L., Dour, H. J., & Banaji, M. R. (2010) · Psychological Science · doi:10.1177/0956797610364762 · Cited by 624
van Heeringen, K., & Mann, J. J. (2014) · The Lancet Psychiatry · doi:10.1016/s2215-0366(14)70220-2 · Cited by 550
Self-citationLopez-Duran, N. L., Kovacs, M., & George, C. J. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.03.016 · Cited by 425
“While some meta-analyses of the DST in adult depression exist (see for example, Mann et al., 2006; Nelson and Davis, 1997; Ribeiro et al., 1993), none of them focused on the DST responses or hypercortisolaemiaof depressedvs. non-depressedadults.”
MethodUnderstanding the Complex of Suicide in Depression: from Research to Clinics
Orsolini, L., Latini, R., Pompili, M., Serafini, G., Volpe, U., Vellante, F., Fornaro, M., Valchera, A., Tomasetti, C., Fraticelli, S., et al. (2020) · Psychiatry Investigation · doi:10.30773/pi.2019.0171 · Cited by 444
Candidate endophenotypes for genetic studies of suicidal behavior
Mann, J. J., Arango, V. A., Avenevoli, S., Brent, D. A., Champagne, F. A., Clayton, P., Currier, D., Dougherty, D. M., Haghighi, F., Hodge, S. E., et al. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.11.021 · Cited by 398
Self-citation
Metadata
- Authors
- Mann, J. J., Currier, D., Stanley, B., Oquendo, M. A., Amsel, L. V., & Ellis, S. P.
- Affiliations
- New York State Psychiatric Institute (US)
- Corresponding author
- Mann, J. John
- Venue
- The International Journal of Neuropsychopharmacology
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-06-21
- Volume
- 9
- Issue
- 04
- Pages
- 465
- ISSN
- 1461-1457 (ISSN-L)
- 1469-5111
- OpenAlex
- W2137625559
- Cited by
- 215
- References
- 55
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 5 · 2023: 9 · 2022: 8 · 2021: 14 · 2020: 16 · 2019: 5 · 2018: 24 · 2017: 6 · 2016: 14 · 2015: 7 · 2014: 12 · 2013: 16 · 2012: 7
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The International Journal of Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH48514, MH 62184, R01MH048514)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- suicide risk prediction, mood disorders, serotonergic dysfunction, hypothalamic-pituitary-adrenal axis, dexamethasone suppression test, biological predictors, penalized quasi-likelihood
- MeSH terms
- Humans, Predictive Value of Tests, Prospective Studies, Suicide, Biomarkers, Mood Disorders
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