본문 바로가기
KERD
논문KCI 등재

응급실 내원 환자에서 자살시도와 말초 혈액 지표 간의 연관성

Relationship Between Suicide Attempts and Peripheral Blood Markers in Patients Who Visited the Emergency Department

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류정신과학

초록

ObjectivesZZWe investigate relationship between suicide attempts and peripheral blood inflammatory markers in patients visiting the emergency department (ED) for psychiatric consultations, aiming to identify potential biomarkers for predicting suicide risk. MethodsZZWe retrospectively reviewed medical records of 569 patients who were referred to psychiatric consultation at the ED from January 1, 2022 to December 31, 2022. Demographic and clinical characteristics, and various blood test markers, were analyzed. Analyses were performed to compare differences in blood markers between suicide attempters and non-attempters and among those with varying histories of suicide attempts. ResultsZZAmong 569 patients, 398 (69.9%) had attempted suicide. Significant differences in leukocytes, lymphocytes, eosinophils, red blood cells (RBCs), lactate dehydrogenase (LDH), and ketone bodies were observed between suicide attempters and non-attempters. Further analysis revealed that patients with a history of suicide attempts had higher lymphocyte and eosinophil counts but lower LDH and ketone body levels. An increasing frequency of past suicide attempts correlated with higher lymphocyte and eosinophil count and lower neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune inflammatory index, glucose, LDH, and ketone body levels. ConclusionsZZWe identify blood markers associated with suicide attempts, indicating that leukocyte, lymphocyte, eosinophil, RBC count, LDH, and ketone body levels could serve as potential biomarkers for assessing suicide risk. Findings underscore importance of biological assessments in conjunction with psychological evaluations in predicting and preventing suicide attempts. Further research is needed to validate these biomarkers and understand mechanisms.

Abstract

ObjectivesZZWe investigate relationship between suicide attempts and peripheral blood inflammatory markers in patients visiting the emergency department (ED) for psychiatric consultations, aiming to identify potential biomarkers for predicting suicide risk. MethodsZZWe retrospectively reviewed medical records of 569 patients who were referred to psychiatric consultation at the ED from January 1, 2022 to December 31, 2022. Demographic and clinical characteristics, and various blood test markers, were analyzed. Analyses were performed to compare differences in blood markers between suicide attempters and non-attempters and among those with varying histories of suicide attempts. ResultsZZAmong 569 patients, 398 (69.9%) had attempted suicide. Significant differences in leukocytes, lymphocytes, eosinophils, red blood cells (RBCs), lactate dehydrogenase (LDH), and ketone bodies were observed between suicide attempters and non-attempters. Further analysis revealed that patients with a history of suicide attempts had higher lymphocyte and eosinophil counts but lower LDH and ketone body levels. An increasing frequency of past suicide attempts correlated with higher lymphocyte and eosinophil count and lower neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune inflammatory index, glucose, LDH, and ketone body levels. ConclusionsZZWe identify blood markers associated with suicide attempts, indicating that leukocyte, lymphocyte, eosinophil, RBC count, LDH, and ketone body levels could serve as potential biomarkers for assessing suicide risk. Findings underscore importance of biological assessments in conjunction with psychological evaluations in predicting and preventing suicide attempts. Further research is needed to validate these biomarkers and understand mechanisms.

참고문헌 (48)

  1. Suicide worldwide in 2019, "World Health Organization", World Health Organization, ~ (2021)
  2. World health statistics 2017: monitoring health for the SDGs, sustainable development goals, "World Health Organization", World Health Organization, ~ (2017)
  3. "2022 cause of death statistics results: statistics Korea" (2022)[URL]
  4. Mental health action plan 2013 - 2020, "World Health Organization", World Health Organization, ~ (2013)
  5. Blasco-Fontecilla H, "Combining scales to assess suicide risk", J Psychiatr Res, 46, pp.1272~1277 (2012)
  6. Finkelstein Y, "Risk of suicide following deliberate self-poisoning", JAMA Psychiatry, 72, pp.570~575 (2015)
  7. Turecki G, "Suicide and suicidal behaviour", Lancet, 387, pp.1227~1239 (2016)
  8. Dantzer R, "Inflammation: from molecular and cellular mechanisms to the clinic", pp.767~784 (2017), Wiley
  9. Köhler CA, "Peripheral cytokine and chemokine alterations in depression : a meta-analysis of 82 studies", Acta Psychiatr Scand, 135, pp.373~387 (2017)
  10. Yuan N, "Inflammation-related biomarkers in major psychiatric disorders : a cross-disorder assessment of reproducibility and specificity in 43 meta-analyses", Transl Psychiatry, 9, pp.233~ (2019)
  11. Courtet P, "Neuroinflammation in suicide : toward a comprehensive model", World J Biol Psychiatry, 17, pp.564~586 (2016)
  12. Niciu MJ, "Biomarkers in mood disorders research : developing new and improved therapeutics", Rev Psiquiatr Clin, 41, pp.131~134 (2014)
  13. Chen X, "Increased C-reactive protein concentrations were associated with suicidal behavior in patients with depressive disorders : a meta-analysis", Psychiatry Res, 292, pp.113320~ (2020)
  14. Chang CC, "The relationships of current suicidal ideation with inflammatory markers and heart rate variability in unmedicated patients with major depressive disorder", Psychiatry Res, 258, pp.449~456 (2017)
  15. Park RJ, "Association between high sensitivity CRP and suicidal ideation in the Korean general population", Eur Neuropsychopharmacol, 27, pp.885~891 (2017)
  16. Russell AE, "Evidence for an association between inflammatory markers and suicide : a cohort study based on 359, 849 to 462, 747 Taiwanese adults", J Affect Disord, 281, pp.967~971 (2021)
  17. Gundogdu Meydaneri G, "Can neutrophil lymphocyte ratio predict the likelihood of suicide in patients with major depression?", Cureus, 10, pp.e2510~ (2018)
  18. Velasco Á, "Neutrophil-to-lymphocyte ratio : a potential new peripheral biomarker of suicidal behavior", Eur Psychiatry, 63, pp.e14~ (2020)
  19. Chen RA, "TNFAIP3 mRNA level is associated with psychological anxiety in major depressive disorder", Neuroimmunomodulation, 24, pp.271~275 (2017)
  20. Bergmans RS, "Inflammation as a unique marker of suicide ideation distinct from depression syndrome among U. S. adults", J Affect Disord, 245, pp.1052~1060 (2019)
  21. Bai S, "Potential biomarkers for diagnosing major depressive disorder patients with suicidal ideation", J Inflamm Res, 14, pp.495~503 (2021)
  22. Coryell W, "Aggression, impulsivity and inflammatory markers as risk factors for suicidal behavior", J Psychiatr Res, 106, pp.38~42 (2018)
  23. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders (DSM-5)" (2013), American Psychiatric Association
  24. Barr B, "Suicides associated with the 2008-10 economic recession in England : time trend analysis", BMJ, 345, pp.e5142~ (2012)
  25. Cooper B, "Economic recession and mental health : an overview", Neuropsychiatr, 25, pp.113~117 (2011)
  26. Zeppegno P, "Suicide attempts and emergency room psychiatric consultation", BMC Psychiatry, 15, pp.13~ (2015)
  27. Lim M, "Difference in suicide methods used between suicide attempters and suicide completers", Int J Ment Health Syst, 8, pp.54~ (2014)
  28. Rich CL, "Similarities in diagnostic comorbidity between suicide among young people in Sweden and the United States", Acta Psychiatr Scand, 86, pp.335~339 (1992)
  29. Fawcett J, "Time-related predictors of suicide in major affective disorder", Am J Psychiatry, 147, pp.1189~1194 (1990)
  30. Bauer ME, "Inflammation in psychiatric disorders : what comes first?", Ann N Y Acad Sci, 1437, pp.57~67 (2019)
  31. Hong H, "Pathophysiological role of neuroinflammation in neurodegenerative diseases and psychiatric disorders", Int Neurourol J, 20(Suppl 1), pp.S2~S7 (2016)
  32. Wang AK, "Meta-analysis of cerebrospinal fluid cytokine and tryptophan catabolite alterations in psychiatric patients : comparisons between schizophrenia, bipolar disorder, and depression", Schizophr Bull, 44, pp.75~83 (2018)
  33. Johnston JN, "Suicide biomarkers to predict risk, classify diagnostic subtypes, and identify novel therapeutic targets : 5 years of promising research", Int J Neuropsychopharmacol, 25, pp.197~214 (2022)
  34. Batty GD, "Systemic inflammation and suicide risk : cohort study of 419 527 Korean men and women", J Epidemiol Community Health, 72, pp.572~574 (2018)
  35. Keaton SA, "An inflammatory profile linked to increased suicide risk", J Affect Disord, 247, pp.57~65 (2019)
  36. Han CH, "Asthma and other allergic diseases in relation to suicidal behavior among South Korean adolescents", J Psychosom Res, 115, pp.94~100 (2018)
  37. Rengasamy M, "Cross-sectional and longitudinal relationships between complete blood count measures and adolescent suicidal behavior", J Affect Disord Rep, 15, pp.100684~ (2024)
  38. Yao Q, "Low levels of serum LDH are associated with depression and suicide attempts", Gen Hosp Psychiatry, 79, pp.42~49 (2022)
  39. Adeva-Andany M, "Comprehensive review on lactate metabolism in human health", Mitochondrion, 17, pp.76~100 (2014)
  40. Vallée A, "Reprogramming energetic metabolism in Alzheimer’s disease", Life Sci, 193, pp.141~152 (2018)
  41. Dong SY, "The epigenetic regulation of HIF-1α by SIRT1 in MPP(+)treated SH-SY5Y cells", Biochem Biophys Res Commun, 470, pp.453~459 (2016)
  42. Morssinkhof MWL, "Associations between sex hormones, sleep problems and depression : a systematic review", Neurosci Biobehav Rev, 118, pp.669~680 (2020)
  43. Kohli MA, "The neuronal transporter gene SLC6A15 confers risk to major depression", Neuron, 70, pp.252~265 (2011)
  44. Beydoun MA, "Role of depressive symptoms in explaining socioeconomic status disparities in dietary quality and central adiposity among US adults : a structural equation modeling approach", Am J Clin Nutr, 90, pp.1084~1095 (2009)
  45. Whipp AM, "Ketone body 3-hydroxybutyrate as a biomarker of aggression", Sci Rep, 11, pp.5813~ (2021)
  46. Swogger MT, "The relationship of outwardly-directed aggression to suicidal ideation and suicide attempts across two high-risk samples", Psychol Violence, 4, pp.184~195 (2014)
  47. O’Donovan A, "Suicidal ideation is associated with elevated inflammation in patients with major depressive disorder", Depress Anxiety, 30, pp.307~314 (2013)
  48. Janelidze S, "Cytokine levels in the blood may distinguish suicide attempters from depressed patients", Brain Behav Immun, 25, pp.335~339 (2011)

관련 논문AI추천

이 간행물의 다른 논문 (4건)