future suicide attempts

New Blood Test Predicts Future Suicide Attempts

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About one million people per year commit suicide—or about one person every 40 seconds. However, a new blood test could help determine if a patient is or will be suicidal. It could drastically improve the chances of survival.

The need for such a test arises more often than you might think. Doctors in emergency rooms sometimes can’t identify if patients intentionally overdosed or injured themselves or if the incidents were accidental, impeding the doctors’ ability to decide treatment plans for a patient. Alexander Niculescu of Indiana University developed a blood test and questionnaire that can predict who within a group of men with psychological disorders will develop suicidal feelings in the next year.

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Blood tests can be used to determine which of a patient’s genes are being expressed.

Sally Adee, reporting for New Scientist, explains:

To develop the test, over several years Niculescu’s team took blood samples from 217 men undergoing various psychiatric treatments. They compared changes in gene expression in 37 of them who developed suicidal feelings with previously published work and with post-mortem samples of 26 men who had killed themselves. They identified 11 gene changes that could be biological markers for spotting people who might be considering suicide, and they monitored these same markers in a test group of 265 men with psychiatric conditions.

The questionnaire asked the subjects about their physical energy as well as their feelings about their accomplishments, but avoided direct questions about suicide. In a trial of 108 people, the scientists’ predictions of suicidal ideation was 92% accurate, and in a second trial of 157 people, they predicted which men would be hospitalized from a suicide attempt that year with 71% accuracy.

The test was especially accurate when predicting suicidal thoughts within the next year in people with bipolar disorder, predicting correctly 98% of the time. It even predicted with 94% accuracy who would make a serious suicide attempt that would require hospitalization.

Other methods to detect psychiatric disorders are often subjective, but this test uses biomarkers, or biological indicators of a disease. In this case, the biomarker is in the patient’s gene expression as measured by the RNA levels in their blood. (Translation of DNA to RNA is the first step when a gene is expressed. Many of our genes are not expressed at any given time.) Still, biomarkers aren’t a panacea because the genetic biomarkers won’t occur in all patients with a psychiatric disorder. Plus, if doctors start to rely on them heavily, they could overlook the correct disease if the patient doesn’t have the biomarkers for it.

There are doubts about its effectiveness on the general population, since only 16 people out of every 100,000 commit suicide. Right now, the test could provide too many false positives and false negatives for use in the general population to be safe, but could be helpful for those already diagnosed with psychological disorders, since doctors could make further decisions on treatment of those patients, including the length of hospital stays and medication.

Blood test reveals biomarkers for future suicide attempts .

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© Thomas Peter
US scientists have managed to find certain biomarkers in blood that can help predict a potential suicide victim, says the study, adding that it can give an early warning of some individuals who may commit an “impulsive suicide act.”

The method includes blood tests and questionnaires, implemented as apps on tablets, that together are able to predict with about 92-percent accuracy which patients will think of suicide or even try to commit it, says a press release about the research carried out at Indiana University.

The questionnaires alone are able to predict “the onset of significant suicidal thoughts” with more than 80-percent accuracy, the research paper adds.

“We now have developed a better panel of biomarkers that are predictive across several psychiatric diagnoses. Combined with the apps, we have a broader spectrum predictor for suicidality,” said Dr Niculescu, director of the Laboratory of Neurophenomics at the Institute of Psychiatric Research at the IU School of Medicine, one of the co-authors of the study.

Neither of the apps, developed separately, asks the participant directly if they are planning to commit suicide.

“One of the apps assesses measures of mood and anxiety; the other asks questions related to life issues including physical and mental health, addictions, cultural factors and environmental stress,” the press release says.

Niculescu and his colleagues have been following a large group of male patients for three years. They have been diagnosed with mental illnesses, including bipolar disorder.

“Suicide is a big problem in psychiatry. It’s a big problem in the civilian realm, it’s a big problem in the military realm and there are no objective markers,” added the scientist.

In the blood samples of these patients the scientists were able to find certain “biomarkers at significantly higher levels in the blood of both bipolar disorder patients with thoughts of suicide as well in a group of people who had committed suicide.”

The scientists detected the SAT1 marker and a series of other markers in the blood of the patients, which indicated a propensity to suicide. They found the same markers in the blood of suicide victims.

“This suggests that these markers reflect more than just a current state of high risk, but could be trait markers that correlate with long term risk,” said Niculescu.

According to the researcher, there are people who will not “reveal they are having suicidal thoughts when you ask them, who then commit it and there’s nothing you can do about it.”

“We need better ways to identify, intervene and prevent these tragic cases…Over a million people each year worldwide die from suicide and this is a preventable tragedy,” he said, adding that the paper is a “first ‘proof of principle’ for a test that could provide an early warning of somebody being at higher risk for an impulsive suicide act.”

He added the research is not complete, as it must be carried out on females as well. It must also take into consideration other groups, such as people who have less impulsive, more deliberate and planned subtypes of suicide.

“Suicide is complex: in addition to psychiatric and addiction issues that make people more vulnerable, there are existential issues related to lack of satisfaction with one’s life, lack of hope for the future, not feeling needed, and cultural factors that make suicide seem like an option.”