Leo Sher, M.D.

Our research work, “Association of testosterone levels and future suicide attempts in females with bipolar disorder” was published 10 years ago in the September 2014 issue of the Journal of Affective Disorders (1). This was the first prospective study on the relation between suicidal behavior and testosterone in women. We examined whether testosterone is related to the course of bipolar disorder at baseline and whether blood testosterone levels predict suicide attempts on follow-up.

Females with a DSM-IV diagnosis of a bipolar disorder in a depressive or mixed episode with at least one past suicide attempt were enrolled. Demographic and clinical parameters were assessed and recorded. Plasma testosterone was assayed using a double antibody radioimmunoassay procedure. Patients were followed up prospectively for up to 2.5 years.

At baseline, testosterone levels positively correlated with the number of past major depressive episodes and suicide attempts but negatively with the Reasons for Living Scale scores. The mean interval of prospective observation between the enrollment in the study and the first suicide attempts was 458.5±311.6 days. The Cox proportional hazards regression analysis demonstrated that higher baseline testosterone levels predicted suicide attempts during the follow up period: HR=169, Wald=6.575, df=1, p=0.01, which means an increase in the testosterone level by 0.1 ng/ml (10 ng/dl) increases the probability of suicide attempt 16.9 times. Our study shows that testosterone levels may predict suicide attempts in women.

Reference

1. Sher L, Grunebaum MF, Sullivan GM, Burke AK, Cooper TB, Mann JJ, Oquendo MA. Association of testosterone levels and future suicide attempts in females with bipolar disorder. J Affect Disord. 2014 Sep;166:98-102. doi: 10.1016/j.jad.2014.04.068. Epub 2014 May 5.