Thyroid-stimulating hormone, fasting blood glucose and suicidal ideation in Chinese adolescents with major depressive disorder: a cross-sectional study
Whether thyroid-stimulating hormone levels, glycolipid metabolism parameters, and their associations with suicidal ideation (SI) in adolescents with MDD can serve as clinically useful biomarkers requires further validation in larger prospective studies.
Abstract
Background Thyroid function and glycolipid metabolic alterations are often associated with major depressive disorder (MDD), yet their roles in suicide risk among adolescents with MDD remain unclear. This study aimed to investigate thyroid-stimulating hormone (TSH) levels, glycolipid metabolism parameters, and their associations with suicidal ideation (SI) in adolescents with MDD. Methods This cross-sectional study was conducted at one general hospital and one psychiatric hospital in Anhui Province, China. Socio-demographic data and laboratory parameters were collected from participants, and the patients’ depressive symptoms and SI severity were assessed using the 24-item Hamilton Depression Rating Scale (HAMD-24) and the Positive and Negative Suicide Ideation Inventory (PANSI), respectively. TSH levels and glycolipid metabolism parameters were also measured. Results A total of 146 adolescents with MDD and 70 healthy controls (HCs) were enrolled in this study. Compared with HCs, patients had lower fasting blood glucose (FBG) levels (P < 0.001). Logistic regression analyses showed that a worse relationship with family, a higher HAMD-24 total score, and higher TSH and FBG levels were independently associated with concurrent SI in adolescents with MDD (all P < 0.05). Furthermore, receiver operating characteristic (ROC) curve analysis showed that the combination of these four factors had a good discriminatory ability for SI, with an area under the curve (AUC) of 0.851. Conclusion In this cross-sectional study, TSH and FBG levels were associated with SI in adolescents with MDD. Nevertheless, whether these parameters can serve as clinically useful biomarkers requires further validation in larger prospective studies.
Non-suicidal self-injury (NSSI) is a deliberate, repetitive act resulting in tissue damage without suicidal intent and is frequently associated with depressive disorders. Nesfatin-1, an anorexigenic peptide expressed in the hypothalamus, has been implicated in stress-related psychopathologies beyond its metabolic functions. This study aimed to investigate the relationship between serum nesfatin-1 levels and non-suicidal self-injury in adolescents diagnosed with major depressive disorder (MDD).
This study included 40 adolescents aged 12–18 years with MDD, 41 adolescents with MDD and comorbid NSSI, and 45 healthy controls. All participants were medication-free for at least eight weeks prior to enrollment. Psychiatric diagnoses were established using K-SADS-PL. Depressive symptom severity and self-injurious behaviors were assessed using the CDI and ISAS, respectively. Serum nesfatin-1 levels were measured using a sandwich enzyme-linked immunosorbent assay (ELISA).
Serum nesfatin-1 levels differed significantly among the three groups (
p
< 0.001) and were highest in the MDD+NSSI group. Both patient groups exhibited significantly higher nesfatin-1 levels than healthy controls, and the MDD+NSSI group showed significantly higher levels than the MDD group (
p
= 0.010), despite comparable depressive symptom severity between the two patient groups. Serum nesfatin-1 levels were positively correlated with depressive symptom severity (Spearman’s ρ = 0.691,
p
< 0.001). ROC curve analyses demonstrated good discriminative ability of nesfatin-1 for distinguishing patient groups from healthy controls and fair discriminative ability for differentiating adolescents with MDD+NSSI from those with MDD alone (AUC = 0.671, 95% CI: 0.553–0.789,
p
= 0.008). CDI scores did not differ between the two patient groups (
p
= 0.059) despite both being significantly higher than those of the control group (
p
< 0.001).
Serum nesfatin-1 levels were associated with both depressive symptom severity and NSSI in adolescents with MDD. Notably, nesfatin-1 levels differentiated adolescents with MDD+NSSI from those with MDD alone despite comparable depressive symptom severity between the two patient groups. These findings suggest that nesfatin-1 may be involved in neurobiological processes underlying self-injurious behavior in adolescent depression. Future longitudinal studies with larger samples are needed to further clarify the role and clinical relevance of nesfatin-1 in adolescents with depression and NSSI.
Not applicable.
B. Onal, H. Arslan, Cansu Çobanoğlu Osmanlı et al.· BMC Psychiatry· 0 citations
Background/aim Major depressive disorder (MDD) is a common psychiatric condition characterized by depressive symptoms and suicide-related clinical features. Vitamin D status has been investigated as a potential clinical correlate of depression and suicidal ideation, but the direction and specificity of these associations remain uncertain. This cross-sectional study aimed to examine the associations among serum 25-hydroxyvitamin D [25(OH)D] levels, depressive symptom severity, suicidal ideation, and suicide-related cognitive–affective dimensions in adults diagnosed with MDD. Materials and methods This cross-sectional study included 97 adults aged 18–65 years who were diagnosed with MDD according to DSM-5 criteria. Depressive symptom severity and suicide-related outcomes were assessed using the Hamilton Depression Rating Scale (HDRS), Suicidal Ideation Scale (SIS), and Suicide Probability Scale (SPS). Vitamin D status was classified as deficient (<20 ng/mL), insufficient (20–29 ng/mL), or sufficient (≥30 ng/mL). Associations were examined using multivariable generalized linear models adjusted for available sociodemographic and clinical covariates. Results Vitamin D deficiency was observed in 61.9% of participants and the mean serum 25(OH)D level was 18.4 ± 11.9 ng/mL. Lower serum 25(OH)D levels were significantly associated with higher HDRS, SIS, and SPS total/subscale scores. In adjusted models, higher serum 25(OH)D levels remained inversely associated with HDRS scores, SIS scores, and total SPS scores. Parental status was also associated with lower SIS scores, while a history of suicide attempts was associated with higher SPS–Suicidal Ideation scores. Conclusion Lower serum 25(OH)D levels were associated with greater depressive symptom severity and higher suicide-related scale scores in adults with MDD, particularly across cognitive–affective domains relevant to suicide probability. However, given the study’s cross-sectional single-center design, absence of a healthy control group, modest sample size, and adjustment limited to available covariates, these findings should be interpreted as associations rather than evidence of causality, directionality, or established biomarker utility.
Elif Küçük, Feride Uysal, Seda Şenkardeş Kandemir et al.· Turkish Journal of Medical S...· 0 citations
Background: Non-suicidal self-injury (NSSI) is a common behavior among adolescents with major depressive disorder (MDD). Although depression severity is often emphasized, emerging evidence suggests that anhedonia and circadian characteristics may also contribute to NSSI. This study examined associations between NSSI, anhedonia, and chronotype in adolescents with MDD.Methods: The study included 104 adolescents (aged 12–18 years) with MDD, divided into NSSI+ (n = 52) and NSSI− (n = 52) groups. NSSI was assessed through a clinical interview based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria. Depression severity, anhedonia, and chronotype were assessed using the Beck Depression Inventory (BDI), Snaith–Hamilton Pleasure Scale (SHAPS), and Children’s Chronotype Questionnaire (CCTQ). Group comparisons, correlation analyses, and hierarchical logistic regression models were performed.Results: Adolescents with NSSI showed significantly higher SHAPS (p < 0.001), BDI (p = 0.007), and CCTQ scores (p < 0.001). SHAPS and CCTQ scores showed moderate positive correlations with NSSI (both p < 0.001), whereas BDI scores showed a weaker association (p = 0.007). In regression analyses, parental psychiatric history (p = 0.006), SHAPS (p = 0.027), and CCTQ scores (p = 0.018) remained significant independent predictors of NSSI, whereas BDI scores lost statistical significance (p = 0.621).Conclusion: The findings of the present study suggest that NSSI in adolescents with MDD may show stronger associations with specific dimensions such as anhedonia and circadian characteristics than with overall depression severity.
O. Karakuş· Archives of Current Medical...· 0 citations
Background: A substantial proportion of adolescents with major depressive disorder (MDD) engage in non-suicidal self-injury (NSSI); however, the biological and psychological factors differentiating those with and without NSSI remain poorly characterized. This study aimed to investigate whether serum beta-endorphin levels, psychological pain, and anhedonia differ between these groups and to explore their associations with the presence of NSSI. Methods: The study sample comprised adolescents prospectively recruited during the study period and diagnosed with MDD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria. Participants were categorized into adolescents with NSSI (NSSI+) and those without NSSI (NSSI−). Assessments included the Children’s Depression Inventory (CDI), Psychache Scale (PAS), and Snaith-Hamilton Pleasure Scale (SHAPS). Serum beta-endorphin levels were measured using enzyme-linked immunosorbent assay (ELISA) from blood samples collected after an overnight fast. Results: The study cohort consisted of 104 adolescents with MDD, including 52 participants in the NSSI+ group and 52 in the NSSI− group. The sample comprised 85 females (81.7%) and 19 males (18.3%). Compared with the NSSI− group, adolescents in the NSSI+ group demonstrated significantly lower serum beta-endorphin levels and significantly higher levels of depressive symptoms, psychological pain, and anhedonia (all p < 0.05). In multivariable analyses, greater depression severity, higher psychological pain, and lower beta-endorphin levels were independently associated with the presence of NSSI. Exploratory mediation analyses suggested an indirect association between depression severity and NSSI through psychological pain. Conclusions: These findings highlight the relevance of both psychological and neurobiological factors in NSSI among adolescents with MDD and suggest that an integrated assessment of these factors may help identify adolescents at increased risk of this form of self-harm.
Rabia Sevcan Karaaslan, O. Karakuş, Nergis Eyüpoğlu et al.· ALPHA PSYCHIATRY· 0 citations
Background: Major depressive disorder (MDD) has frequently been associated with inflammation; however, the relationship between antidepressant-related side effects and inflammatory markers remains unclear. This study investigated the associations of antidepressant side effects with the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-HDL ratio (MHR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC) count, and C-reactive protein (CRP). Methods: The study included 60 patients aged 18–65 years who met DSM-5 criteria for MDD, had used antidepressants for at least one month, and developed side effects, together with 60 sociodemographically matched healthy controls. Complete blood count (CBC), CRP, and HDL levels were measured from venous blood samples, and NLR, MHR, MLR, and PLR were calculated. Patients completed the Udvalg Kliniske Undersøgelser (UKU) Side Effect Rating Scale, Clinical Global Impression Scale, Montgomery–Åsberg Depression Rating Scale (MADRS), and Hamilton Anxiety Scale (HAM-A). Only side effects considered medication-related according to the UKU causality assessment were included. Analyses were performed using SPSS 24.0. Results: Concentration problems correlated negatively with neutrophil levels and NLR. Sedation/drowsiness correlated positively with MHR and MLR, and increased dreaming correlated positively with platelet levels. Weight gain correlated positively with neutrophil, lymphocyte, and WBC counts and negatively with PLR. Erectile dysfunction correlated negatively with PLR, orgasmic dysfunction with monocyte levels, vaginal dryness with neutrophil levels, and physical dependence with NLR. Conclusions: Antidepressant-related side effects showed several uncorrected associations with peripheral inflammatory markers, none of which survived correction for multiple comparisons (Benjamini–Hochberg false discovery rate). As the first exploratory investigation of this relationship, these preliminary, hypothesis-generating findings may inform understanding of side-effect mechanisms and support future, adequately powered longitudinal studies aimed at enhancing treatment adherence and reducing relapse and chronicity.
Ezgi Çankaya İnan, Mahmut Bulut, Betul Uyar· Journal of Clinical Medicine· 0 citations
The implication of vitamin D in the pathophysiology of depression has generated interest regarding its role as a biomarker in the context of mental health. Given the limited data on this association in the Romanian population, the present study aimed to evaluate the correlation between vitamin D status and the severity of depressive symptomatology in a sample of adult patients from Romania. This cross-sectional study was conducted on 90 patients diagnosed with major depressive disorder who were admitted to the Department of Psychiatry at the County Clinical Emergency Hospital of Bihor during the period of 2024–2025. Serum vitamin D concentrations were determined by measuring the 25-hydroxyvitamin D metabolite in blood using the chemiluminescence microparticle immunoassay method. The severity of depressive symptomatology was quantified using two validated scales: the Beck Depression Inventory-II (BDI-II) and the Hamilton Depression Rating Scale 17 (HAM-D17). Multivariable linear regression and ordered probit regression were used to assess the relationship between vitamin D status and depression severity, with adjustments for relevant covariates. A statistically significant negative association was identified for the BDI-II scale (B = −0.3170444, β = −0.2621328, p = 0.007) and the HAM-D17 scale (B = −0.1495026, β = −0.2829461, p = 0.002), which remained robust after adjustment for covariates (BDI-II: B = −0.2110473, β = −0.1744942, p = 0.050; HAMD17: B = −0.1153659, β = −0.2183397, p = 0.018). In comparison with subjects with vitamin D deficiency, those with sufficient levels presented a significantly lower probability of belonging to higher severity categories of depression for both scales (BDI-II: coefficient = −0.6855429, p = 0.004; HAM-D17: coefficient = −0.7029572, p = 0.005). The study highlighted a statistically significant negative correlation between vitamin D status and depression severity, which remained after adjustment for covariates. Sufficient vitamin D levels were associated with a significantly lower probability of belonging to a higher depression severity category compared with deficiency.
Andreea Roșian, O. Micle, L. Dobjanschi et al.· International Journal of Mol...· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
