Article2005

Neuroactive Steroids and Suicidality in Posttraumatic Stress Disorder

Marian I. Butterfield · Karen M. Stechuchak · Kathryn M. Connor · Jonathan R. T. Davidson · Courteney L MacKuen · Anne M Pearlstein +1 more

80 citations0/0 files storedAmerican Journal of Psychiatry

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Posttraumatic Stress Disorder Research Suicide and Self-Harm Studies Stress Responses and Cortisol

Abstract

OBJECTIVE: Recent studies suggest that neuroactive steroids may be altered in posttraumatic stress disorder (PTSD). Since high rates of suicidality accompany PTSD, the authors investigated neuroactive steroid levels and correlations to suicide attempts in veterans with this disorder. METHOD: Male veterans with PTSD enrolled in a larger study during inpatient hospitalization (N=130) were assessed for suicidal ideation or suicide attempt in the last 6 months. Serum levels of dehydroepiandrosterone (DHEA), androstenedione, testosterone, and estradiol were determined. The authors investigated associations between neuroactive steroids and suicidality. RESULTS: High rates of suicidality were observed. Close to 70% of these patients had suicidal thoughts, and 25% had attempted suicide in the last 6 months. Patients who had attempted suicide demonstrated significantly higher median DHEA levels than those who had not attempted suicide (15.6 versus 8.3 ng/ml), an association that persisted after adjustment for age. CONCLUSIONS: These findings suggest that higher DHEA levels may be linked to suicidality in veterans with PTSD and may be associated with the risk of self-harm.

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References

1996Psychometric properties of the PTSD checklist (PCL)1999Prevalence of and Risk Factors for Lifetime Suicide Attempts in the National Comorbidity Survey 2002Current status of cortisol findings in post-traumatic stress disorder 2003Association of Comorbid Posttraumatic Stress Disorder and Major Depression With Greater Risk for Suicidal Behavior 1998Suicidal behavior after severe trauma. Part 1: PTSD diagnoses, psychiatric comorbidity, and assessments of suicidal behavior 2000Elevated circulatory level of GABAA – antagonistic neurosteroids in patients with combat-related post-traumatic stress disorder

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