Department of Psychiatry, Chonnam National University Medical School, Republic of Korea.
Department of Emergency Medicine, Chonnam National University Medical School, Republic of Korea.
Br J Psychiatry. 2021 Nov;219(5):598-605. doi: 10.1192/bjp.2021.82.
The role of childhood abuse and serum brain-derived neurotrophic factor (BDNF) levels in suicidal behaviour is controversial.
We aimed to investigate the individual and interactive effects of the childhood abuse and serum BDNF on suicidal behaviour before and after pharmacologic treatment in patients with depressive disorders.
At baseline, reported childhood emotional, physical and sexual abuse were ascertained and serum BDNF levels were measured in 1094 patients with depressive disorder, 884 of whom were followed during a 1-year period of stepwise pharmacotherapy. Suicidal behaviours evaluated at baseline were previous suicide attempt and baseline suicide severity, and suicidal behaviours evaluated at follow-up were increased suicide severity and fatal/non-fatal suicide attempt. Individual and interactive associations of any childhood abuse and serum BDNF levels with four types of suicidal behaviours were analysed using logistic regression models, after adjusting relevant covariates.
Individual associations of childhood abuse were significant only with previous suicide attempt, and no significant individual associations were found for serum BDNF with any suicide outcome. However, the presence of both childhood abuse and lower serum BDNF levels was associated with the highest prevalence/incidence of all four suicidal behaviours, with significant interactions for baseline suicide severity and fatal/non-fatal suicide attempt during follow-up.
Synergistic interactive effects of child abuse and serum BDNF levels on suicidal behaviours were found before and after pharmacologic treatment in patients with depressive disorders. Information combining childhood abuse and serum BDNF levels could improve predictions of suicidal behaviour in patients with depressive disorders.
童年期虐待和血清脑源性神经营养因子（BDNF）水平与自杀行为的关系存在争议。
我们旨在探讨童年期虐待和血清 BDNF 对抑郁障碍患者药物治疗前后自杀行为的单独和交互作用。
在基线时，确定了报告的童年期情感、身体和性虐待情况，并测量了 1094 例抑郁障碍患者的血清 BDNF 水平，其中 884 例在逐步药物治疗的 1 年期间接受了随访。在基线评估的自杀行为包括既往自杀未遂和基线自杀严重程度，在随访时评估的自杀行为包括自杀严重程度增加和致命/非致命自杀未遂。使用逻辑回归模型，在调整相关协变量后，分析任何童年期虐待和血清 BDNF 水平与四种自杀行为的个体和交互关联。
童年期虐待的个体关联仅与既往自杀未遂显著相关，而血清 BDNF 与任何自杀结局均无显著个体关联。然而，童年期虐待和较低的血清 BDNF 水平同时存在与所有四种自杀行为的最高发生率/发病率相关，且在随访期间与基线自杀严重程度和致命/非致命自杀未遂存在显著交互作用。
在抑郁障碍患者药物治疗前后，发现了童年期虐待和血清 BDNF 水平对自杀行为的协同交互作用。结合童年期虐待和血清 BDNF 水平的信息可以提高对抑郁障碍患者自杀行为的预测。
