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Physical Disease, Inflammation Linked to Suicide Risk in Depression

SAN FRANCISCO — Suicide attempts in those with depression may be linked with the presence of physical disease and inflammation, according to research was recently presented at the American Psychiatric Association Annual Meeting, held May 18-22, 2019, in San Francisco, California.

A case-control study included 1468 individuals who attempted suicide and 14,373 controls, all of whom were diagnosed with depression between 2011 and 2015 and were between 18 and 65 years old. Researchers examined the association between suicide attempt risk and systemic inflammation (measured by C-reactive protein [CRP]) and chronic physical disease. Separate effects of chronic physical disease and systemic inflammation on suicide attempt were assessed using regression models, with stepwise adjustments made for age, race/ethnicity, sex, and number and kind of physical diseases, including stroke, arthritis, chronic lung or heart disease, diabetes, and neoplasm.

There was a significant increase in risk for suicide attempt associated with the number of physical diseases, with a 3.6-fold greater risk for 1 physical disease, a 6.4-fold greater risk for 2 physical diseases, and a 14.9-fold greater risk for 3 physical diseases. Among individuals with available CRP metrics, those with CRP greater than 3 mg/L were 1.9 times more likely than those with values below 1 mg/L to attempt suicide. However, statistical significance was not sustained after controlling for the effect of physical disease.

Researchers wrote, “Presence of physical disease is an important risk factor for suicide attempt among patients with depression. Systemic inflammation is likewise associated with an increased risk for suicide attempt; however, this association appears to be accounted for by the presence of physical disease among patients receiving care in a medical center setting. “

“The results emphasize the importance of assessing the risk of suicide attempt in depressed patients burdened with multiple physical comorbidities,” they concluded.

Reference

Oh KY, Murrough JW. Effects of chronic physical disease and systemic inflammation on suicide risk in patients with depression: a hospital-based case-control study. Poster presented at: American Psychiatric Association Annual Meeting; May 18-22, 2019; San Francisco, CA. Abstract 97.

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