The link between endocrine parameters, serum lithium concentrations, and cognitive functions among individuals with affective disorders at risk of suicidal behavior. A study protocol.

INTRODUCTION

Suicidal behavior is prevalent among individuals with mental disorders and constitutes a major global, clinical, and public health concern. It is generally accepted that the majority of persons who die by suicide are suffering from psychiatric disorders in most cases and that affective disorders make up the single commonest group. Suicide risk is highest during the years immediately following the onset of affective disorders; therefore, identifying risk factors and successful treatment of initially non-suicidal individuals with affective disorders can prevent developing suicidal behavior, help detecting, and predict it. Clarifying risk factors for individual types of major affective disorders could enhance earlier identification of suicidal risk, support preventive interventions and improve the treatment and prognosis of individuals at risk. We have developed a study protocol with the aim to address the complex interaction of endocrine parameters, lithium trace concentrations and cognitive functions with affective disorders and risk of suicidal behavior.

METHOD

A cross-sectional study will be done among individuals hospitalized after a suicidal attempt for treatment of affective disorders (group 1), hospitalized for the treatment of affective disorders without life time history of suicidal behavior (group 2), and control group individuals without life time history of mental disorders or suicidal behavior (group 3). Based on this study design we calculated the appropriate study sample size (N = 210). Venous blood samples of study participants will be collected for the evaluation of endocrine parameters, serum lithium concentrations, liver and kidney function. Data on sociodemographic factors, cognitive functions, history of mental disorders, and suicidality risk will be evaluated using validated questionnaires and instruments. Associations of endocrine parameters, serum lithium concentrations, cognitive functions, and suicidality risk will be analyzed using descriptive and inferential statistics, including linear and logistic regression. Based on this study design we calculated the appropriate study sample size (N = 210). Power analysis has shown that this sample size is appropriate for detection of significant differences between the groups.

CONCLUSION

The findings of the potential influence of the associations between serum lithium trace concentrations, endocrine parameters, and cognitive functions on suicidality risk in individuals with affective disorders may help clinicians effectively plan suicide prevention and timely implement actions for treatment.