Journal
EUROPEAN NEUROPSYCHOPHARMACOLOGY
Volume 24, Issue 12, Pages 1907-1915Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.euroneuro.2014.10.006
Keywords
Bipolar disorder; Suicide attempt; Cerebrospinal fluid; Neuropeptitle Y; Suicide prevention; Biomarker
Funding
- Swedish Foundation for Strategic Research [KF10-0039]
- Swedish Medical Research Council [10414, K2014-62X-14647-12-51, K2010-61P-21568-01-4]
- Swedish Federal Government under the LUA/ALF agreement [ALF 20130032, ALFGBG-142041]
- Karolinska Institutet
- Swedish Foundation for Strategic Research (SSF) [KF10-0039] Funding Source: Swedish Foundation for Strategic Research (SSF)
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The attempted and accomplished suicide rates in patients with bipolar disorder are 40-50% and 15-20%, respectively. No biological markers that help predict suicide been identified. Human and experimental animal data indicate that dysregulation of the neuropeptide Y (NPY) system plays a role in depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of this study was to explore if low cerebrospinal fluid (CSF) NPY is associated with (1) past suicide attempts, (2) future suicide attempts, and (3) trait anxiety. Lumbar puncture was performed on 120 clinically stable patients with bipolar disorder enrolled in the St Garan Bipolar Project, where the number of previous suicide attempts was documented. NPY-like immunoreactivity (NPY-LI) was determined in cerebrospinal fluid (CSF). Patients were reexamined one year after the lumbar puncture and suicide attempts were recorded. NPY-LI was significantly lower in patients with a history of suicide attempt than in patients who had not attempted suicide prior to lumbar puncture. Importantly, NPY-LI was markedly lower in patients who made a suicide attempt during the follow-up period compared to patients who did not. Patients who attempted suicide during the follow-up also had markedly lower NPY-LI than those with previous suicide attempts who did not reattempt. Our results suggest that low CSF NPY-LI predicts future suicide attempts. The data are in line with the hypothesis that NPY signaling is altered in affective disorders and states of emotional dysregulation. (C) 2014 Elsevier B.V. and ECNP. All rights reserved.
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