Orsolini Laura, Longo Giulio, Cavallo Luciano, Volpe Umberto
Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy.
Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy.
Psychoneuroendocrinology. 2025 Nov;181:107612. doi: 10.1016/j.psyneuen.2025.107612. Epub 2025 Sep 19.
Individuals with affective disorders have been consistently found to exert chronic low-grade inflammation, particularly, increased C-reactive protein (CRP) hematic levels were observed in major depressive disorder (MDD) patients. Moreover, an association between suicidal behaviour and increased CRP hematic levels has been documented. Few studies specifically investigated all suicidality spectrum dimensions, by recruiting all affective disorders, e.g. MDD, bipolar disorder type-1 (BD-I), bipolar disorder type-2 (BD-II) and cyclothymic mood disorder (Cyc). Therefore, our study was designed to explore the association between a low-grade inflammatory state (as assessed by high-sensitivity CRP [hsCRP]) and all suicidal spectrum dimensions across affective spectrum disorders in a real-world setting.
A naturalistic observational cross-sectional study was carried out by retrospectively recruiting 225 adult inpatients with affective disorders (MDD, BD-I, BD-II, Cyc). As routine clinical practice, for all patients were collected: a) hsCRP levels within a full laboratory panel; b) anthropometric measures; c) short version of the MINI Suicidal Scale (MINI-5-s); d) short version of the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (brief-TEMPS-M).
Within the total sample, 62.2 % reported thoughts of death in the last month, while 55.6 % experienced current suicidal ideation. According to a logistic regression model, thoughts of death were significantly predicted by higher score at the depressive subscale of TEMPS-M (Exp(B) = 1.069; 95 %IC = 1.021-1.119; p = 0.005) and higher hsCRP levels (Exp(B) = 1.818; 95 %IC = 1.053-3.139; p = 0.032).
Our findings suggest that hsCRP could potentially represent a relatively easy, cheap and early transdiagnostic inflammatory biomarker for suicidality across mood disorders, particularly among those displaying a predominant affective depressive temperament. Further studies should longitudinally explore clinical implication derived by the stratification of mood disorders according to the inflammatory pattern, as well as testing whether anti-inflammatory therapy could represent an early treatment strategy for managing suicidality risk.
一直以来，情感障碍患者被发现存在慢性低度炎症，尤其是在重度抑郁症（MDD）患者中观察到C反应蛋白（CRP）血液水平升高。此外，已有文献记载自杀行为与CRP血液水平升高之间存在关联。很少有研究通过纳入所有情感障碍，如MDD、双相情感障碍1型（BD-I）、双相情感障碍2型（BD-II）和环性心境障碍（Cyc），专门调查自杀倾向谱的所有维度。因此，我们的研究旨在探讨在现实环境中，低度炎症状态（通过高敏CRP [hsCRP]评估）与情感谱系障碍患者自杀倾向谱所有维度之间的关联。
通过回顾性招募225名患有情感障碍（MDD、BD-I、BD-II、Cyc）的成年住院患者，开展了一项自然观察性横断面研究。作为常规临床操作，收集了所有患者的以下信息：a）完整实验室检查中的hsCRP水平；b）人体测量指标；c）迷你自杀量表简版（MINI-5-s）；d）孟菲斯、比萨、巴黎和圣地亚哥气质评估简版（brief-TEMPS-M）。
在总样本中，62.2%的患者报告在过去一个月中有死亡念头，而55.6%的患者目前有自杀意念。根据逻辑回归模型，TEMPS-M抑郁分量表得分较高（Exp(B)=1.069；95%置信区间=1.021 - 1.119；p=0.005）和hsCRP水平较高（Exp(B)=1.818；95%置信区间=1.053 - 3.139；p=0.032）可显著预测死亡念头。
我们的研究结果表明，hsCRP可能是一种相对简便、廉价且早期的跨诊断自杀倾向炎症生物标志物，适用于各类心境障碍，尤其是那些表现出主要情感抑郁气质的患者。进一步的研究应纵向探索根据炎症模式对心境障碍进行分层所产生的临床意义，以及测试抗炎治疗是否可作为管理自杀风险的早期治疗策略。
