Work

PS278. Association of testosterone levels and future suicide attempts in women with bipolar disorder: A prospective study

Year: 2016

Type: conference-abstract

Abstract: Background: Considerable evidence suggests that testosterone may play a role in the pathophysiology of mood disorders in females. This is the first prospective study to examine whether blood testosterone levels predict suicide attempts in females with bipolar disorder. We hypothesized that testosterone may be related to the course of bipolar illness and suicidal behavior in women with bipolar disorder based on observations that testosterone may affect mood and suicidality. We examined whether testosterone is related to the course of illness at baseline and whether blood testosterone levels predict suicide attempts on follow-up. Methods: Females with a DSM-IV diagnosis of a bipolar disorder in a depressive or mixed episode with at least one past suicide attempt were enrolled. We limited this study to previous suicide attempters in order to have a higher risk group for suicide attempt on follow-up and thus sufficient power to allow detection of a relationship to testosterone and clinical variables. Demographic and clinical parameters were assessed and recorded. Plasma testosterone was assayed using a double antibody radioimmunoassay procedure. Patients were followed up prospectively for up to 2.5 years. The SPSS 19 statistical program was used to perform statistical analyses. Results: At baseline, testosterone levels positively correlated with the number of past major depressive episodes (r=0.353, p=0.014) and suicide attempts (r=0.408, p=0.003) but negatively with the Reasons for Living Scale scores (r=-0.373, p=0.014). We did not find a correlation between testosterone levels and Brown Goodwin lifetime aggression scale scores (r=0.126, p=0.395), the number of manic episodes (r=0.077, p=0.605), current severity of suicide ideation (r=0.133, p=0.425), depression (r=0.027, p=0.850) or hopelessness (r<0.001, p=0.997). The Cox proportional hazards regression analysis demonstrated that higher baseline testosterone levels predicted suicide attempts during the follow up period: HR=169, Wald=6.575, df=1, p=0.01, which means an increase in the testosterone level by 0.1 ng/ml (10 ng/dl) increases the probability of suicide attempt 16.9 times. Discussion: This prospective study shows that testosterone levels may predict suicide attempts in women with bipolar illness. The results of this study also suggest that testosterone levels may be related to the course of bipolar disorder. Our results are consistent with observations suggesting that testosterone influences mood and behavior in females. For example, an association between blood or saliva testosterone levels and depressive symptoms in women was observed by several research groups. Possibly, depression mediates the relation between testosterone and suicidality.

Source: The International Journal of Neuropsychopharmacology

DOI: 10.1093/ijnp/pyw043.278