Jiang Zhaowei, Dong Liying, Zhang Yajie, Mao Hongjing, Luo Fugang, Song Mingfen
The Fourth Clinical Medical College of Zhejiang Chinese Medical University, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Psychiatry, Shaoxing Seventh People's Hospital, Shaoxing, China.
Front Psychiatry. 2025 Apr 30;16:1563819. doi: 10.3389/fpsyt.2025.1563819. eCollection 2025.
To evaluate the association between cortisol levels and suicide in patients with depression through a meta-analysis to provide an early warning for suicide prevention.
Databases including China National Knowledge Infrastructure (CNKI), Weipu Database (VIP), Wanfang Database, PubMed, Cochrane Library, Web of Science, and Embase were searched to collect case-control studies, cohort studies, and cross-sectional studies investigating the relationship between cortisol levels and suicide in patients with depression. The meta-analysis was conducted using Stata 18.0. Meanwhile, we collected data from 131 participants to measure their cortisol levels, including Hair cortisol levels (HCL) were calculated for the 0-1 cm and 1-2 cm segments.
The meta-analysis indicated that cortisol levels in depressed patients with suicidal behavior were significantly higher than healthy individuals (SMD = 0.350, 95% CI [0.003, 0.696]). However, the cortisol levels in patients with suicidal behavior were only slightly higher than those in patients without suicidal behavior, and the pooled effect size (SMD = 0.108, 95% CI [-0.151, 0.367]) was non-significant. The depression patients with suicidal behaviors had significantly lower levels of 0-1 cm HCL (3.46 ± 1.92 ng/mg) than those in the depression patients without suicidal ideation (5.43 ± 2.42 ng/mg) (P=0.003) and in the depression patients with suicidal ideation (5.04 ± 2.30 ng/mg) (P=0.037). Similarly, 1-2 cm HCL was significantly lower in the depression with suicidal behavior group (3.21 ± 1.47 ng/mg) than in the depression without suicidal ideation group (5.65 ± 3.59 ng/mg) (P=0.009) and in the depression with suicidal ideation group (5.10 ± 2.88 ng/mg) (P=0.050).
The study found that cortisol levels in patients with depression who exhibited suicidal behavior were higher than those in the healthy population. However, no significant difference in cortisol levels was observed between patients with depression and suicidal behavior and those without suicidal behavior. The experiment revealed that patients with depression and suicidal behavior had lower hair cortisol levels (HCL) than those depression without suicidal behavior.
通过荟萃分析评估抑郁症患者皮质醇水平与自杀之间的关联，为自杀预防提供早期预警。
检索中国知网（CNKI）、维普数据库（VIP）、万方数据库、PubMed、Cochrane图书馆、Web of Science和Embase等数据库，收集调查抑郁症患者皮质醇水平与自杀之间关系的病例对照研究、队列研究和横断面研究。使用Stata 18.0进行荟萃分析。同时，我们收集了131名参与者的数据以测量他们的皮质醇水平，包括计算0-1厘米和1-2厘米段的毛发皮质醇水平（HCL）。
荟萃分析表明，有自杀行为的抑郁症患者的皮质醇水平显著高于健康个体（标准化均数差[SMD]=0.350，95%可信区间[0.003, 0.696]）。然而，有自杀行为的患者的皮质醇水平仅略高于无自杀行为的患者，合并效应量（SMD=0.108，95%可信区间[-0.151, 0.367]）无统计学意义。有自杀行为的抑郁症患者0-1厘米HCL水平（3.46±1.92纳克/毫克）显著低于无自杀意念的抑郁症患者（5.43±2.42纳克/毫克）（P=0.003）和有自杀意念的抑郁症患者（5.04±2.30纳克/毫克）（P=0.037）。同样，有自杀行为的抑郁症组1-2厘米HCL水平（3.21±1.47纳克/毫克）显著低于无自杀意念的抑郁症组（5.65±3.59纳克/毫克）（P=0.009）和有自杀意念的抑郁症组（5.10±2.88纳克/毫克）（P=0.050）。
该研究发现，有自杀行为的抑郁症患者的皮质醇水平高于健康人群。然而，有自杀行为的抑郁症患者与无自杀行为的抑郁症患者之间未观察到皮质醇水平的显著差异。实验显示，有自杀行为的抑郁症患者的毛发皮质醇水平（HCL）低于无自杀行为的抑郁症患者。
