Association between C-reactive protein and suicidal behavior in an adult inpatient population

Gibbs, Hunter M.; Davis, Lauren Evoy; Han, Xiaotong; Clothier, Jeffrey; Eads, Lou Ann; Cáceda, Ricardo

doi:10.1016/j.jpsychires.2016.04.002

Cited by 47 publications

(39 citation statements)

References 50 publications

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“…Recent reports correlate suicide-related attempts with an inflammatory state, including increased levels of blood tumour necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), and decreased levels of IL-2. [37][38][39] Our findings are supported by prior studies, which were carried out with depressed subjects. Recently, Gibbs et al 38 found that as CRP level increased, the likelihood of patients' association with the suicidal group increased.…”

Section: Anatolian Journal Of Psychiatry 2017; 18(5):438-445supporting

confidence: 89%

“…[37][38][39] Our findings are supported by prior studies, which were carried out with depressed subjects. Recently, Gibbs et al 38 found that as CRP level increased, the likelihood of patients' association with the suicidal group increased. However, Vargas et al 40 did not discover any differences in CRP levels between patients with and without a history of suicide tendencies.…”

Section: Anatolian Journal Of Psychiatry 2017; 18(5):438-445supporting

confidence: 89%

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The relationships between low grade inflammation, demographic and clinical characteristics in patients with obsessive compulsive disorder

Ekinci¹,

Ekinci²

2017

Anadolu Psikiyatri Derg

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Section: Anatolian Journal Of Psychiatry 2017; 18(5):438-445supporting

confidence: 89%

Section: Anatolian Journal Of Psychiatry 2017; 18(5):438-445supporting

confidence: 89%

The relationships between low grade inflammation, demographic and clinical characteristics in patients with obsessive compulsive disorder

Ekinci¹,

Ekinci²

2017

Anadolu Psikiyatri Derg

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“…Prior work has shown anxiety (OR 1.59), alcohol abuse (OR 2.47), and substance abuse (OR 2.66) to be associated with suicide in depressed patients (Hawton et al, 2013); our results also highlight dementia, psychosis, and bipolar disorder as important risk factors for suicide attempt in patients who initially received a diagnosis of depression. We found an association between elevated CRP and ESR with increased risk of suicide attempt, replicating previous smaller scale findings of CRP and suicide (Courtet et al, 2015;Gibbs et al, 2016) in a larger number of suicide attempters. In our study, the association between CRP and suicide attempt was no longer significant when controlling for types or number of chronic physical diseases.…”

Section: Psychological Medicinesupporting

confidence: 87%

Effects of chronic physical disease and systemic inflammation on suicide risk in patients with depression: a hospital-based case–control study

Dam

Doucette

et al. 2019

Psychol. Med.

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BackgroundFew studies have examined the concurrent effects of physical disease and systemic inflammation on suicide risk in patients with depression. The authors investigated the independent contributions of chronic physical disease and systemic inflammation as indexed by C-reactive protein (CRP), on risk of suicide attempt.MethodsIn this case–control study, 1468 cases of suicide attempters and 14 373 controls, both aged 18–65 years with a diagnosis of depression during 2011–2015, were identified from the hospital-wide database. Regression models were implemented to identify separate effects of physical diseases and systemic inflammation indexed by CRP, on risk of suicide attempt.ResultsCompared with having no physical disease, having one, two, and three or more physical diseases was associated with a 3.6-, 6.4-, and 14.9-fold increase in odds of making a suicide attempt, respectively, after adjusting for age, sex, and race/ethnicity. In a sub-sample of cases and controls with available CRP values, patients with high CRP (>3 mg/L) had 1.9 times the odds of suicide attempt compared with patients with low CRP (<1 mg/L). This association was no longer significant when controlling for the effect of physical disease.ConclusionsThe presence of physical disease is an important risk factor for suicide attempt among patients with depression. Systemic inflammation is likewise associated with increased risk for suicide attempt, however, this association appears to be accounted for by the presence of physical disease among patients receiving care in a medical center setting. Healthcare providers should consider the risk of suicide attempt in depressed patients burdened with multiple comorbidities.

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“…It is worth noting that infections activate neuroinflammatory mechanisms associated with the pathophysiology of SB. Third, acute-phase inflammatory markers such as C-reactive protein (CRP) have been associated with SB [27,28]. Fourth, the therapeutic benefit of ketamine for reducing suicidal ideation may be related, at least in part, to its NMDA antagonist effect [29].…”

Section: Inflammation and Suicidalitymentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio: A potential new peripheral biomarker of suicidal behavior

et al. 2020

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Background. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as important peripheral inflammatory biomarkers. Recent data suggest a possible role of the immune system in the pathophysiology of suicidal behavior (SB). The aim of this study is to evaluate the association among NLR, MLR, and PLR and SB in patients with major depressive disorder (MDD), and to test its validity as a biomarker for suicidality. Methods. We evaluated 538 patients with MDD (mean age [standard deviation] = 43.87 [14.36] years; females: 68.8%). A logistic regression model was estimated to determine the independent factors associated with suicide risk in patients with and without a history of suicide attempt (SA). Results. Three hundred ninety-three patients (74.7%) had a personal history of SA. Patients with a previous SA were more frequently female (71.9% vs. 59.6%; p = 0.007), significantly younger (41.20 vs. 51.77 years; p < 0.001), had lower depression severity at enrolment (15.58 vs. 18.42; p < 0.000), and significantly higher mean NLR and PLR ratios (2.27 vs. 1.68, p = 0.001; 127.90 vs. 109.97, p = 0.007, respectively). In the final logistic regression model, after controlling for age, sex, and depression severity, NLR was significantly associated with SB (β = 0.489, p = 0.000; odds ratio [95% confidence intervals] = 1.631 [1.266–2.102]). We propose a cut-off value of NLR = 1.30 (sensitivity = 75% and specificity = 35%). Conclusions. Our data suggest that NLR may be a valuable, reproducible, easily accessible, and cost-effective strategy to determine suicide risk in MDD.

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Association between C-reactive protein and suicidal behavior in an adult inpatient population

Cited by 47 publications

References 50 publications

The relationships between low grade inflammation, demographic and clinical characteristics in patients with obsessive compulsive disorder

The relationships between low grade inflammation, demographic and clinical characteristics in patients with obsessive compulsive disorder

Effects of chronic physical disease and systemic inflammation on suicide risk in patients with depression: a hospital-based case–control study

Neutrophil-to-lymphocyte ratio: A potential new peripheral biomarker of suicidal behavior

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