Suicide is a major public health problem in the US. To date, the main risk factors identified in multiple clinical samples include male sex, living alone and suicidal ideation. Recent data suggest that demonstrating non-suppression to cortisol on the dexamethasone suppression test (DST) may be a more robust clinical predictor than these other variables. This is further supported by post-mortem data indicating chronic activation of the HPA axis such as increased adrenal weight and increased POMC mRNA in the anterior pituitary. Furthermore, strong evidence supports the effects of cortisol in modulating brain serotonin systems. This project depends upon the existence of a large database of subjects with the diagnosis of major depression who received the DST between 1978 and 1987. All subjects also received SADS interviews and weekly Ham-D ratings during assessment and follow-up. After identifying index cases, we will examine mortality rates particularly suicide in DST positive and negative subjects as well as examining the relationship between a number of other potential risk factors for suicide and completed suicide.
| Coryell, William; Fiedorowicz, Jess; Zimmerman, Mark et al. (2008) HPA-axis hyperactivity and mortality in psychotic depressive disorder: preliminary findings. Psychoneuroendocrinology 33:654-8 |
| Coryell, William H (2006) Clinical assessment of suicide risk in depressive disorder. CNS Spectr 11:455-61 |
| Coryell, William; Young, Elizabeth; Carroll, Bernard (2006) Hyperactivity of the hypothalamic-pituitary-adrenal axis and mortality in major depressive disorder. Psychiatry Res 142:99-104 |
| Coryell, William; Young, Elizabeth A (2005) Clinical predictors of suicide in primary major depressive disorder. J Clin Psychiatry 66:412-7 |
