Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Apr-Jun;13(2):188-194.
doi: 10.4183/aeb.2017.188.

CORTISOL LEVELS AND SUICIDE IN BIPOLAR I DISORDER

A Giurgiuca  1 , B Nemes  2 , S Schipor  3 , A Caragheorgheopol  3 , V Boscaiu  4 , D Cozman  2 , C Tudose  1
Affiliations

CORTISOL LEVELS AND SUICIDE IN BIPOLAR I DISORDER

A Giurgiuca et al. Acta Endocrinol (Buchar). 2017 Apr-Jun.

Abstract

Context: Hypothalamic-pituitary-adrenal (HPA) axis irregularities have been described both in bipolar disorder and suicidal behaviour, but few studies have examined the relationship between suicidal behaviours and cortisol levels in bipolar disorder.

Objective: We compared HPA axis activity in bipolar I (BPD I) individuals with and without suicidal ideation and behaviour through multiple measurement of serum and salivary cortisol.

Design: Cross-sectional, observational study.

Subjects and methods: 75 BPD I patients were assigned into 3 groups (no history of suicidal behaviour, history of suicidal ideation, history of suicide attempt), according to the C-SSRS. Socio-demographical and clinical data was obtained by using MINI 6.0 and a semi-structured questionnaire. Salivary samples were collected using Sarstedt Cortisol Salivette synthetic swab system for two consecutive days at 08:00, 16:00, 23:00 and salivary cortisol concentrations were determined by ELISA technique. A unique 1mg dose of dexamethasone was administered on the first day, at 23:00, after the collection of the saliva sample. Blood was collected on the first day at 8:00 AM and basal morning serum cortisol levels were determined by immunoassay with fluorescence detection.

Results: Cortisol parameters in our BPD I sample did not vary significantly in respect to suicidal history. However, patients with a history of suicidal ideation have significantly higher total cortisol outputs than patients with no history of suicidal behaviour in the 18 to 40 age category compared with the above 40 age category.

Conclusions: Total cortisol daily output varies significantly in an age-dependent manner in respect to suicidal thoughts in BPD I individuals.

Keywords: HPA; bipolar; cortisol; dexamethasone; salivary cortisol; suicide; suicide risk.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest concerning this article.Authors would like to thank Alexander Strulovici for his generous feedback, while writing the article. Authors would like to respectfully thank fellow doctors from the “Prof. Al. Obregia Clinical Hospital” for their support in recruiting the sample and thank all participants for consenting to participate in the present study.

References

    1. Martin EI, Ressler KJ, Binder E, Nemeroff CB. The neurobiology of anxiety disorders: brain imaging, genetics, and psychoneuroendocrinology. Psychiatr Clin North Am. 2009;32(3):549–575. - PMC - PubMed
    1. McEwen BS, Gianaros PJ. Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease. Ann N Y Acad Sci. 2010;1186:190–222. - PMC - PubMed
    1. Bauer M, Dinan T. Hypothalamic-pituitary-adrenal axis and hypothalamic-pituitary-thyroid axis and their treatment impact. The Bipolar Book: History, Neurobiology, and Treatment. 2015:137.
    1. Grunze H. The clinical side of bipolar disorders. Pharmacopsychiatry. 2011;44(Suppl 1):S43–48. - PubMed
    1. Watson S, Gallagher P, Ritchie JC, Ferrier IN, Young AH. Hypothalamic-pituitary-adrenal axis function in patients with bipolar disorder. Br J Psychiatry. 2004;184:496–502. - PubMed

LinkOut - more resources