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Testosterone levels in suicide attempters with bipolar disorder
Authors:Leo Sher  Michael F Grunebaum  Gregory M Sullivan  Ainsley K Burke  Thomas B Cooper  J John Mann  Maria A Oquendo
Affiliation:New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA; James J. Peters Veterans' Administration Medical Center and Mount Sinai School of Medicine, New York, NY, USA.
Abstract:ObjectiveThe best known neurobehavioral effects of testosterone are on sexual function and aggression. However, testosterone and other androgens may be involved in the pathophysiology of mood disorders and suicidal behavior. This is the first study to examine whether there is a relation between testosterone levels and clinical parameters in bipolar suicide attempters.MethodsPatients with a DSM-IV diagnosis of a bipolar disorder (16 males and 51 females), in a depressive or mixed episode with at least one past suicide attempt were enrolled. Demographic and clinical parameters, including lifetime suicidal behavior, were assessed and recorded. Plasma testosterone was assayed using a double antibody radioimmunoassay procedure.ResultsThe number of major depressive episodes, the maximum lethality of suicide attempts, and the testosterone levels were higher in men compared to women. Current suicidal ideation scores were higher in women compared to men. Controlling for sex, we found that testosterone levels positively correlated with the number of manic episodes and the number of suicide attempts.ConclusionOur findings are consistent with previous observations of the association between testosterone levels and parameters of mood and behavior. This study suggests that testosterone levels may be related to the course of bipolar disorder and suicidal behavior. Further studies of the role of testosterone in the neurobiology of mood disorders and suicidal behavior are merited.
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