Questionnaires

Biomarkers and Questionnaires Predict Suicide Risk

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At a Glance

  • Researchers identified several genes in blood whose activity is related to suicidal thoughts and actions in men with psychiatric disorders.
  • The genetic findings, combined with app-based questionnaires, may help clinicians predict which patients are likely to attempt suicide.

Man looking out a window.

Researchers have been seeking a way to objectively measure a person’s risk for suicide.

More than 41,000 Americans commit suicide each year. That’s more than twice the number killed annually by homicide. Most people who end their own lives have a mental disorder such as depression, schizophrenia, or bipolar disorder.

Efforts to reduce suicides have focused on identifying and treating those at risk. However, asking people if they’re suicidal isn’t always a reliable approach. Finding a way to objectively measure a person’s risk for suicide is thus an important area of research. Some researchers are developing questionnaires that measure the likelihood of someone committing suicide. Others are looking for biological markers of people who are suicidal.

A study led by researchers at Indiana University School of Medicine combined these approaches. Their work was funded by an NIH Director’s New Innovator Award and the U.S. Department of Veterans Affairs. Results appeared online in Molecular Psychiatry on August 18, 2015.

The researchers studied 217 male psychiatric patients at the Indianapolis VA Medical Center during multiple visits several months apart. The scientists measured the men’s thoughts of suicide through extensive interviews and took blood samples. They identified 37 patients whose thoughts of suicide increased between visits. Those patients’ blood samples were analyzed to find genes with changes in activity, or expression, between visits. Those genes were ranked based on prior research linking them to suicide risk. The researchers then measured the expression of these top-ranked genes in blood samples from 26 men who had committed suicide.

The team also developed 2 apps that use questionnaires to measure risk factors for suicide. The first collects details on a patients’ emotional state. The second asks about factors known to influence suicide risk, such as life events, stress, and mental health. Both could predict thoughts of suicide more than 85% of the time. These questionnaires were then combined with the most predictive gene biomarkers to create a universal predictive measure called UP-Suicide.

The team tested UP-Suicide in a separate group of 108 psychiatric patients to examine its ability to predict thoughts of suicide and a group of 157 patients to examine ability to predict future hospitalizations. The tool predicted which patients would go on to have serious suicidal thoughts with 92% accuracy. It also predicted with 71% accuracy which patients would be hospitalized for suicidal behaviors in the year following testing. The tool was even more accurate for patients with bipolar disorder, with 98% and 94% accuracy, respectively.

“We believe that widespread adoption of risk prediction tests based on these findings during health care assessments will enable clinicians to intervene with lifestyle changes or treatments that can save lives,” says lead researcher Dr. Alexander B. Niculescu.

Because the team studied only male psychiatric patients, further research will be needed to understand how well this approach can predict suicidal thoughts and behaviors in other populations, such as women and those who aren’t psychiatric patients.

Does Sodium Intake Affect Mortality and CV Event Risk?

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Sodium intake may not be associated with mortality or incident cardiovascular events in older adults, according to a study published Jan. 19 in the JAMA: Internal Medicine.

In the Health, Aging and Body Composition (Health ABC) Study, initiated in 1997, researchers assessed self-reported sodium intake from 2,642 Medicare beneficiaries, ages 71-80 years old. Participants were excluded for difficulties with walking or activities of daily life, cognitive impairment, inability to communicate, and previous heart failure (HF). At the first annual follow-up visit, researchers recorded food intake as reported by participants, specifically examining sodium intake. After 10 years, 34 percent of patients had died, while 29 percent and 15 percent had developed cardiovascular disease and HF, respectively.

The results of the study showed that there was no association between participant-reported sodium intake and 10-year mortality, incident HF or incident cardiovascular disease. Further, there was no indication that consuming less than 1,500 mg/d of sodium benefitted participants any more than consuming the recommended amount (1,500-2,300 mg/d). However, the study showed a slight potential for harm when participants had a sodium intake of greater than 2,300 mg/d, especially in women and African Americans.

The authors note that while the food frequency questionnaire used by participants at the first annual follow-up has limitations in its accuracy, “self-reported adoption of a low-salt diet was not associated with significantly higher risk for [any] events.” They conclude that moving forward, there is a need for further research and stronger evidence in order to create better recommendations for older adults.

– See more at: http://www.acc.org/latest-in-cardiology/articles/2015/01/16/15/47/does-sodium-intake-affect-mortality-and-cv-event-risk-acc-news-story?wt.mc_id=fb#sthash.vE0R3iGF.dpuf