ETUDE RECHERCHE Niveaux de monoamines dans le liquide céphalo-rachidien chez les tentatives de suicide: une revue systématique et une méta-analyse

Review article : Cerebrospinal fluid levels of monoamines among suicide attempters: a systematic review and random-effects meta-analysis

Author links open overlay panelNicolas Hoertel ¹²³ Hélène Cipel ¹ Carlos Blanco ⁴ Maria A. Oquendo ⁵ Pierre Ellul ⁶ Edourd Leaune ⁷ Frédéric Limosin ¹²³ Hugo Peyre ⁶ Jean-François Costemale-Lacoste ^89
1 Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France
² AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Département de Psychiatrie
³ INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
⁴ Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland
⁵ Perelman School of Medicine, University of Pennsylvania
⁶ Child and Adolescent Psychiatry, Robert Debré Hospital, Paris Diderot University, Sorbonne Paris Cité, Paris, France
⁷ CPS/Psymobile - CH Le Vinatier / IRPhiL - Université Lyon 3, France
⁸ GHU Paris, Psychiatrie et Neurosciences, Paris University
⁹ INSERM UMRS 1178, CESP, Team « MOODS » Le Kremlin-Bicêtre, France

Journal of Psychiatric Research Available online 3 February 2021

Available online 3 February 2021.

https://doi.org/10.1016/j.jpsychires.2021.01.045Get rights and content

Abstract

Background

It remains unclear whether the dopaminergic and noradrenergic systems may be implied in suicide attempt risk. In addition, although the serotonergic system has been extensively studied, no formal meta-analysis has been performed to examine its association with suicide attempt.

Methods

Using PRISMA methodology, we performed a systematic literature review and random-effects meta-analyses of the differences in cerebrospinal fluid (CSF) levels of 5-HIAA, HVA and MHPG between suicide attempters and individuals who never attempted suicide.

Results

We identified 30 studies including 937 suicide attempters and 1128 non-attempters; 29 of them measured CSF levels of 5-HIAA, 22 measured CSF levels of HVA and 14 measured CSF levels of MHPG. CSF levels of 5-HIAA and HVA were significantly lower in suicide attempters than in non-attempters [SMD= -0.43 (95% CI: -0.71 to -0.15; p<0.01) and SMD= -0.45 (95% CI: -0.72 to -0.19; p<0.01), respectively]. We did not find a significant association between CSF MHPG levels and suicide attempt.

Limitations

Our analyses relied on a limited number of studies of good quality and most studies included small sample sizes.

Conclusion

Both serotonin and dopamine systems may play a role in suicide attempt risk. Our findings suggest that a silo approach to biomarkers should be phased out in favor of the study of multiple systems in parallel and in the same populations to progress in the identification of the biological components independently associated with suicide risk, with the goal of identifying new treatment targets and improving suicide risk prediction.

Keywords

suicide attempt serotonin dopamine noradrenalin biomarker cerebrospinal fluid violent meta-analysis

 

https://www.sciencedirect.com/science/article/abs/pii/S002239562100056X