Blood Biomarkers, Questionnaires May Identify Suicide Risk in Women

Two new app-based questionnaires designed for female psychiatric patients along with a biomarker-detecting blood test may help clinicians successfully identify suicide risk in women being treated for mental health disorders, according to a new study by researchers at the Indiana University (IU) School of Medicine.

In combination, the questionnaires and biomarkers were able to predict future instances of suicidal thoughts with 82 percent accuracy, and future suicide-associated hospitalizations with 78 percent accuracy.

The study follows similar research published in 2015 showing that questionnaires and blood-based biomarkers could accurately predict which men were at greatest risk for suicidal ideation and behavior.

Although women have a lower rate of suicide completion that men — likely because they tend to use less violent methods — they actually have a higher rate of suicide attempts, said the study’s principal investigator, Alexander B. Niculescu III, M.D., Ph.D., professor of psychiatry and medical neuroscience at the IU School of Medicine.

“Women have not been adequately studied in research about suicide, and we did not know how well we would be able to define objective predictors of suicide in women,” said Niculescu.

“It was important to determine whether biomarkers and app-based questionnaires could be used to make predictions among women, and whether such tests can be adjusted for gender to be more accurate,” said Niculescu, who is also attending psychiatrist and research and development investigator at the Richard L. Roudebush Veterans Affairs Medical Center.

“These results suggest that the best way to proceed would be to use gender-tailored approaches,” he said.

For the study, the researchers regularly evaluated 51 female participants who had been diagnosed with psychiatric disorders such as bipolar disorder, depression, and schizophrenia. The researchers paid close attention to the women’s suicidal ideation during each visit, noting whether the patients went from extremes of having no thoughts of committing suicide to high levels of suicidal ideation.

In 12 patients identified as having extreme swings of suicide ideation, genomic analyses were conducted to identify genes whose activity was significantly different between the two states.

Next, the researchers confirmed the suspected biomarkers using blood samples from six women who had committed suicide. Fifty such biomarkers were validated.

While some of the biomarkers were the same as those found in the male patient studies, others differed, such as those involved in mechanisms related to the body’s responses to the psychiatric drug lithium, and genes involved with circadian rhythms. The findings raise important questions about potential diagnostic and treatment approaches, said Niculescu.

The two app-based questionnaires assess a patient’s risk of suicidal thoughts and attempts, with one app measuring mood and anxiety, while the other app addresses life issues such as physical and mental health, social isolation and environmental stress. Neither app directly asks whether the individual is having suicidal thoughts.

The researchers also evaluated blood samples and medical records of different groups of 33 women with the same mental illness diagnoses to confirm that the biomarkers and apps predicted suicidal ideation.

Together, the biomarkers and app were able to predict future instances of suicidal thoughts with 82 percent accuracy, and future suicide-associated hospitalizations with 78 percent accuracy.

Niculescu cautions that since the study participants had already been diagnosed with psychiatric illnesses, it is still unknown how well the biomarkers would work among people who have not been diagnosed with mental illness.

The study paper titled “Towards understanding and predicting suicidality in women: biomarkers and clinical risk assessment,” is published in the journal Molecular Psychiatry.

Source: Indiana University