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Adrenocortical function and suicidal behavior in depressive disorders.

R P Brown, B Mason, P Stoll

    Psychiatry Research
    |April 1, 1986
    PubMed
    Summary
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    Abnormal adrenocortical function, assessed via plasma cortisol and dexamethasone suppression tests (DSTs), was not directly linked to suicidal behavior in major depressive disorder patients. However, DST nonsuppression correlated with depression severity, age, and delusions.

    Area of Science:

    • Neuroendocrinology
    • Psychiatry
    • Clinical Psychology

    Background:

    • Suicidal behavior is a significant concern in major depressive disorder.
    • Adrenocortical function abnormalities have been hypothesized to play a role in suicidal behavior.

    Purpose of the Study:

    • To investigate the association between adrenocortical function and suicidal behavior in patients with major depressive disorder.
    • To compare plasma cortisol levels and dexamethasone suppression test (DST) results among patients with recent, past, and no history of suicide attempts.

    Main Methods:

    • Morning and afternoon plasma cortisol levels were measured.
    • A 1-mg dexamethasone suppression test (DST) was administered to 65 patients with primary major depressive disorder.
    • Patients were categorized based on their history of suicide attempts (recent, past, never).

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    Main Results:

    • Plasma cortisol levels did not significantly differ across the three groups of patients (recent, past, never suicide attempts).
    • Nonsuppression on the DST was associated with the presence of delusions, increasing age, and global severity of depression.
    • Nonsuppression on the DST was not significantly associated with suicide attempts.

    Conclusions:

    • Abnormal adrenocortical function, as indicated by DST nonsuppression, is not directly correlated with suicidal behavior in major depressive disorder.
    • DST nonsuppression in major depressive disorder is linked to specific clinical features like delusions and increasing age, rather than suicidal behavior itself.