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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH064834-02
Application #
6619524
Study Section
Special Emphasis Panel (ZRG1-BBBP-2 (01))
Program Officer
Dolan-Sewell, Regina
Project Start
2002-07-25
Project End
2005-06-30
Budget Start
2003-07-01
Budget End
2005-06-30
Support Year
2
Fiscal Year
2003
Total Cost
$268,900
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Psychiatry
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
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