Skip to main content
SpringerLink
Log in

Biomarkers of Suicide: Predicting the Predictable?

  • Chapter
  • First Online:
Understanding Suicide

Abstract

To date, the identification of individuals at risk of suicide is based on subjective reports. Given that individuals at risk often do not disclose their suicidal thoughts, the introduction of objective measures – such as biomarkers – of suicide risk might help in predicting which individuals will eventually die by suicide. Biomarkers have a potentially relevant role in the prediction of suicide, as an adjunct to, rather than a substitute for, current clinical practice. Within the context of the stress-diathesis model of suicidal behavior, the most relevant biomarkers for estimating suicide risk are non-suppression in the dexamethasone suppression test (DST) – a biomarker of stress – and reduced concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in the cerebrospinal fluid (CSF), a biomarker of diathesis. Given the multi-determined nature of suicide, a combination of biological, clinical, neuropsychological, and neuroimaging factors might yield a better estimate of suicide risk than using biomarkers alone and help overcome current limitations in the prediction of suicide.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Asberg M, Traskman L, Thoren P (1976) 5-HIAA in the cerebrospinal fluid. A biochemical suicide predictor? Arch Gen Psychiatry 33:1193–1197

    Article  CAS  PubMed  Google Scholar 

  • Banerjee R, Ghosh AK, Ghosh B, Bhattacharyya S, Mondal AC (2013) Decreased mRNA and protein expression of BDNF, NGF, and their receptors in the hippocampus from suicide: an analysis in human postmortem brain. Clin Med Insights Pathol 6:1–11

    Article  PubMed  PubMed Central  Google Scholar 

  • Bayard-Burfield L, Alling C, Blennow K, Jonsson S, Traskman-Bendz L (1996) Impairment of the blood-CSF barrier in suicide attempters. Eur Neuropsychopharmacol 6:195–199

    Article  CAS  PubMed  Google Scholar 

  • Blasco-Fontecilla H, Lopez-Castroman J, Giner L, Baca-Garcia E, Oquendo MA (2013) Predicting suicidal behavior: are we really that far along? Comment on “Discovery and validation of blood biomarkers for suicidality”. Curr Psychiatry Rep 15:424

    Article  PubMed  PubMed Central  Google Scholar 

  • Braquehais MD, Picouto MD, Casas M, Sher L (2012) Hypothalamic-pituitary-adrenal axis dysfunction as a neurobiological correlate of emotion dysregulation in adolescent suicide. World J Pediatr 8:197–206

    Article  CAS  PubMed  Google Scholar 

  • Brower V (2011) Biomarkers: portents of malignancy. Nature 471:S19–S21

    Article  CAS  PubMed  Google Scholar 

  • Coryell W, Schlesser M (2001) The dexamethasone suppression test and suicide prediction. Am J Psychiatry 158:748–753

    Article  CAS  PubMed  Google Scholar 

  • Coryell W, Schlesser M (2007) Combined biological tests for suicide prediction. Psychiatry Res 150:187–191

    Article  PubMed  PubMed Central  Google Scholar 

  • Davis AT, Schrueder C (1990) The prediction of suicide. Med J Aust 153:552–554

    CAS  PubMed  Google Scholar 

  • Duman RS, Monteggia LM (2006) A neurotrophic model for stress-related mood disorders. Biol Psychiatry 59:1116–1127

    Article  CAS  PubMed  Google Scholar 

  • Dwivedi Y, Rizavi HS, Conley RR, Roberts RC, Tamminga CA, Pandey GN (2003) Altered gene expression of brain-derived neurotrophic factor and receptor tyrosine kinase B in postmortem brain of suicide subjects. Arch Gen Psychiatry 60:804–815

    Article  CAS  PubMed  Google Scholar 

  • Falcone T, Fazio V, Lee C, Simon B, Franco K, Marchi N, Janigro D (2010) Serum S100B: a potential biomarker for suicidality in adolescents? PLoS One 5:e11089

    Article  PubMed  PubMed Central  Google Scholar 

  • Fawcett J, Busch KA, Jacobs D, Kravitz HM, Fogg L (1997) Suicide: a four-pathway clinical-biochemical model. Ann N Y Acad Sci 836:1981

    Article  Google Scholar 

  • Gerszten RE, Wang TJ (2008) The search for new cardiovascular biomarkers. Nature 451:949–952

    Article  CAS  PubMed  Google Scholar 

  • Golier JA, Marzuk PM, Leon AC, Weiner C, Tardiff K (1995) Low serum cholesterol level and attempted suicide. Am J Psychiatry 152:419–423

    Article  CAS  PubMed  Google Scholar 

  • Jokinen J, Carlborg A, Martensson B, Forslund K, Nordstrom AL, Nordstrom P (2007) DST non-suppression predicts suicide after attempted suicide. Psychiatry Res 150:297–303

    Article  PubMed  Google Scholar 

  • Jokinen J, Martensson B, Nordstrom AL, Nordstrom P (2008) CSF 5-HIAA and DST non-suppression -independent biomarkers in suicide attempters? J Affect Disord 105:241–245

    Article  CAS  PubMed  Google Scholar 

  • Jokinen J, Nordstrom AL, Nordstrom P (2009) Cerebrospinal fluid monoamine metabolites and suicide. Nord J Psychiatry 63:276–279

    Article  PubMed  Google Scholar 

  • Jollant F, Lawrence NL, Olie E, Guillaume S, Courtet P (2011) The suicidal mind and brain: a review of neuropsychological and neuroimaging studies. World J Biol Psychiatry 12:319–339

    Article  PubMed  Google Scholar 

  • Jones R (2010) Biomarkers: casting the net wide. Nature 466:S11–S12

    Article  CAS  PubMed  Google Scholar 

  • Kim YK, Myint AM (2004) Clinical application of low serum cholesterol as an indicator for suicide risk in major depression. J Affect Disord 81:161–166

    Article  CAS  PubMed  Google Scholar 

  • Lee BH, Kim YK (2011) Potential peripheral biological predictors of suicidal behavior in major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 35:842–847

    Article  CAS  PubMed  Google Scholar 

  • Lee JM, Han JJ, Altwerger G, Kohn EC (2011) Proteomics and biomarkers in clinical trials for drug development. J Proteomics 74:2632–2641

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Le-Niculescu H, Levey DF, Ayalew M, Palmer L, Gavrin LM, Jain N, Winiger E, Bhosrekar S, Shankar G, Radel M, Bellanger E, Duckworth H, Olesek K, Vergo J, Schweitzer R, Yard M, Ballew A, Shekhar A, Sandusky GE, Schork NJ, Kurian SM, Salomon DR, Niculescu AB 3rd (2013) Discovery and validation of blood biomarkers for suicidality. Mol Psychiatry 18:1249–1264

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lester D (1995) The concentration of neurotransmitter metabolites in the cerebrospinal fluid of suicidal individuals: a meta-analysis. Pharmacopsychiatry 28:45–50

    Article  CAS  PubMed  Google Scholar 

  • Lindberg G, Rastam L, Gullberg B, Eklund GA (1992) Low serum cholesterol concentration and short term mortality from injuries in men and women. BMJ 305:277–279

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mann JJ, Currier D (2007) A review of prospective studies of biologic predictors of suicidal behavior in mood disorders. Arch Suicide Res 11:3–16

    Article  PubMed  Google Scholar 

  • Mann JJ, Waternaux C, Haas GL, Malone KM (1999) Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry 156:181–189

    CAS  PubMed  Google Scholar 

  • Mann JJ, Currier D, Stanley B, Oquendo MA, Amsel LV, Ellis SP (2006) Can biological tests assist prediction of suicide in mood disorders? Int J Neuropsychopharmacol 9:465–474

    Article  PubMed  Google Scholar 

  • McIntyre RS, Muzina DJ, Kemp DE, Blank D, Woldeyohannes HO, Lofchy J, Soczynska JK, Banik S, Konarski JZ (2008) Bipolar disorder and suicide: research synthesis and clinical translation. Curr Psychiatry Rep 10:66–72

    Article  PubMed  Google Scholar 

  • Meijer OC, De Kloet ER (1998) Corticosterone and serotonergic neurotransmission in the hippocampus: functional implications of central corticosteroid receptor diversity. Crit Rev Neurobiol 12:1–20

    Article  CAS  PubMed  Google Scholar 

  • Oquendo MA, Sullivan GM, Sudol K, Baca-Garcia E, Stanley BH, Sublette ME, Mann JJ (2014) Toward a biosignature for suicide. Am J Psychiatry 171:1259–1277

    Article  PubMed  PubMed Central  Google Scholar 

  • Papadopoulou A, Markianos M, Christodoulou C, Lykouras L (2013) Plasma total cholesterol in psychiatric patients after a suicide attempt and in follow-up. J Affect Disord 148:440–443

    Article  CAS  PubMed  Google Scholar 

  • Poudel-Tandukar K, Nanri A, Iwasaki M, Mizoue T, Matsushita Y, Takahashi Y, Noda M, Inoue M, Tsugane S (2011) Long chain n-3 fatty acids intake, fish consumption and suicide in a cohort of Japanese men and women – the Japan Public Health Center-based (JPHC) prospective study. J Affect Disord 129:282–288

    Article  CAS  PubMed  Google Scholar 

  • Sher L, Carballo JJ, Grunebaum MF, Burke AK, Zalsman G, Huang YY, Mann JJ, Oquendo MA (2006) A prospective study of the association of cerebrospinal fluid monoamine metabolite levels with lethality of suicide attempts in patients with bipolar disorder. Bipolar Disord 8:543–550

    Article  CAS  PubMed  Google Scholar 

  • Singh I, Rose N (2009) Biomarkers in psychiatry. Nature 460:202–207

    Article  CAS  PubMed  Google Scholar 

  • Smith EG, Kim HM, Ganoczy D, Stano C, Pfeiffer PN, Valenstein M (2013) Suicide risk assessment received prior to suicide death by Veterans Health Administration patients with a history of depression. J Clin Psychiatry 74:226–232

    Article  PubMed  PubMed Central  Google Scholar 

  • Sublette ME, Hibbeln JR, Galfalvy H, Oquendo MA, Mann JJ (2006) Omega-3 polyunsaturated essential fatty acid status as a predictor of future suicide risk. Am J Psychiatry 163:1100–1102

    Article  PubMed  Google Scholar 

  • Sunnqvist C, Westrin A, Traskman-Bendz L (2008) Suicide attempters: biological stressmarkers and adverse life events. Eur Arch Psychiatry Clin Neurosci 258:456–462

    Article  PubMed  Google Scholar 

  • Traskman L, Asberg M, Bertilsson L, Sjostrand L (1981) Monoamine metabolites in CSF and suicidal behavior. Arch Gen Psychiatry 38:631–636

    Article  CAS  PubMed  Google Scholar 

  • Tsai AC, Lucas M, Okereke OI, O’Reilly EJ, Mirzaei F, Kawachi I, Ascherio A, Willett WC (2014) Suicide mortality in relation to dietary intake of n-3 and n-6 polyunsaturated fatty acids and fish: equivocal findings from 3 large US cohort studies. Am J Epidemiol 179:1458–1466

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhang L, Su TP, Choi K, Maree W, Li CT, Chung MY, Chen YS, Bai YM, Chou YH, Barker JL, Barrett JE, Li XX, Li H, Benedek DM, Ursano R (2011) P11 (S100A10) as a potential biomarker of psychiatric patients at risk of suicide. J Psychiatr Res 45:435–441

    Article  PubMed  Google Scholar 

  • Zureik M, Courbon D, Ducimetiere P (1996) Serum cholesterol concentration and death from suicide in men: Paris prospective study I. BMJ 313:649–651

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, IDIPHIM-Puerta de Hierro University Hospital, CIBERSAM, Autonoma Univeristy, Madrid, Spain

    Hilario Blasco-Fontecilla MD, PhD

  2. Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, Columbia University, New York, USA

    Maria A. Oquendo MD, PhD

Authors
  1. Hilario Blasco-Fontecilla MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria A. Oquendo MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hilario Blasco-Fontecilla MD, PhD .

Editor information

Editors and Affiliations

  1. Academic Hospital of Montpellier, University of Montpellier, Montpellier, France

    Philippe Courtet

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Blasco-Fontecilla, H., Oquendo, M.A. (2016). Biomarkers of Suicide: Predicting the Predictable?. In: Courtet, P. (eds) Understanding Suicide. Springer, Cham. https://doi.org/10.1007/978-3-319-26282-6_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26282-6_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26280-2

  • Online ISBN: 978-3-319-26282-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation