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22 décembre 2011 4 22 /12 /décembre /2011 22:34
MedWire News : Patients with bipolar disorder (BD) who have a history of suicidal behavior exhibit significantly increased bedtime salivary cortisol levels, results from a US study show.

"Altered functioning of the hypothalamic-pituitary-adrenal (HPA) axis has been reported in suicidal behavior and in BD," write Masoud Kamali (University of Michigan, Ann Arbor) and colleagues in the Journal of Affective Disorders.

"However, many studies of HPA axis function in BD have not examined the potential effects of suicidal behavior," they add.

To address this, the researchers studied 136 BD patients and 29 mentally healthy individuals (controls). Of the patients with BD, 56 had a history of suicidal behavior, as assessed using the Diagnostic Interview for Genetic Studies.

Cortisol levels were measured in saliva samples collected from the participants 10-15 min before going to bed at night and 10-15 min after waking up in the morning on 3 consecutive days.

The researchers found that there were no significant differences among the groups regarding average awakening cortisol levels, after adjustment for confounding factors such as age, body mass index, history of substance abuse, mood state, length of illness, and gender.

However, bedtime salivary cortisol levels were a significant 7.4% higher in BD patients with a history of suicidal behavior compared with BD patients without such a history, even after adjustment for confounding factors.
There was no significant difference in bedtime salivary cortisol levels between BD patients without a history of suicidal behavior and controls, after adjustment.

Kamali and team conclude: "In this study, elevated bedtime salivary cortisol was associated with a history of suicidal behavior in bipolar individuals."

They add: "While HPA axis hyperactivity has been closely related to acute mood episodes, based on our findings, it also may be a trait marker of suicidal behavior during euthymic periods in bipolar individuals."

By Mark Cowen


MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

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