Hair cortisol concentrations as a putative biomarker for suicidal behavior

Area of Science:

• Neuroscience
• Psychiatry
• Endocrinology

Background:

• Suicide is a leading cause of death for young adults, especially among psychiatric patients post-hospitalization.
• Predicting suicidal behavior remains a significant clinical challenge.
• Hair cortisol concentration (HCC) reflects long-term Hypothalamic-Pituitary-Adrenal (HPA) axis activity.

Purpose of the Study:

• To investigate hair cortisol concentrations (HCC) as an objective risk marker for suicidal behavior.
• To analyze HCC across the spectrum of suicidal behavior, including suicide death.

Main Methods:

• Examined 238 young adults across the suicide spectrum (suicide, attempt, ideation, psychiatric comparison) and 43 drug overdose deaths.
• Collected data via self-report, clinical interview, medical records, and 3cm hair sampling.
• Utilized multivariate regression to analyze the relationship between HCC and suicidal behavior groups, controlling for covariates.

Main Results:

• Significantly lower HCC was observed in individuals who died by suicide compared to suicide attempters, those with suicidal ideation, and psychiatric comparison individuals.
• Effect sizes (d) ranged from 0.73 to 1.02, indicating moderate to large differences.
• Lower HCC may serve as an objective marker for death by suicide risk.

Conclusions:

• Lower hair cortisol concentrations (HCC) show potential as an objective marker for identifying individuals at high risk for death by suicide.
• These findings have critical clinical implications for suicide risk prediction and prevention strategies.
• Further research with larger cohorts is needed to validate these results and facilitate clinical implementation of HCC assessment.