Hair stress hormones in individuals with a recent suicide attempt experiencing a depressive episode

Background: Stressful events and dysregulation of the hypothalamic-pituitary-adrenal (HPA)- axis contribute to the risk of suicide attempt (SA) in persons in depressive episodes. Hair cortisol, cortisone and dehydroepiandrosterone (DHEA) concentrations may serve as reliable indicators of HPA axis dysregulation prior to SA. Methods: Participants (n = 75; mean age [standard deviation] = 30.0 [10.2] years; n = 49 [65 %] women; Jena site) comprised three groups: individuals with a history of SA approximately one month (SA; n = 22); individuals with a current depressive episode without SA history (CC; n = 31) and healthy individuals (HC; n = 22). SA was defined as self-initiated, potentially injurious behavior accompanied by some intent to die. Stress hormones were measured using LC-MS/MS protocol (days from sampling to analysis = 342 [171]) and logarithmic transformed. Group differences in hair stress hormones with hair segments representing time were tested using linear mixed models on a p < .05 threshold. Exploratory models further examined the effects of childhood abuse, frequency of SAs, suicide intent level and impulsiveness of the last SA of mean hormone levels, on a corrected pcorr< .012 threshold. Results: There was a main effect of group for the DHEA-log (p = .02) and post-hoc tests indicated that SA group had higher DHEA compared to CC (pcorr = .01) and HC (pcorr = .08) in the peri-suicidal period. There were no significant (p < .05) interaction or group effects on cortisol-log and cortisone-log. Preliminary exploratory analyses showed that SA with multiple attempts had higher mean DHEA-log compared to SA with a single suicide attempt (puncorr = .05). Furthermore, there were positive associations between level of suicide intent and both mean cortisol-log (puncorr = .02) and mean cortisone-log (puncorr = .02). Childhood abuse and impulsiveness of the last SA were not related to hair stress hormones. Conclusions: Individuals with a recent history of SA showed alterations in the DHEA hair levels. These results partially support dysregulation of the HPA axis as a biopsychosocial feature of SA. Future longitudinal and experimental studies should investigate whether hair HPA axis hormones can serve as markers of suicidal crisis and vulnerability.