Psychosocial Factors, Pro-Inflammatory Markers & Serum Lipids among Patients with Suicidal Ideation & Suicidal Attempts

Background: Suicide is a worldwide serious problem. It is a leading cause of death, accounting for 1.3% of all deaths worldwide in 2019 and Approximately 703,000 people die by suicide every year. We aimed to study the personal, cognitive, psychosocial, personality traits, psychopathological, pro-inflammatory markers & serum lipids differences between patients with suicidal ideation and patients with suicidal attempts and to assess predictor factors that make suicidal ideation convert to suicidal attempt.

Subjects and Methods: This cross-sectional case control study was carried on participant aged 18 – 50 years, both sexes. Suicidal behavior of the study sample was assessed using Beck Scale for Suicidal Ideation (BSSI) & participants were classified into three equal groups according to their score in BSSI and their history of recent suicidal attempt (suicidal ideation group, suicidal attempt group & control group). Participants’ sociodemographic data were evaluated by a questionnaire designed by the researcher and reviewed by experts. Psychiatric assessment was done using the Mini-International Neuropsychiatric Interview (MINI). Socioeconomic status & cognitive functions were assessed by the socioeconomic status scale for health research in Egypt & the Montreal Cognitive Assessment (MoCA) test, respectively. Personality was assessed by short form of EPQ-R (Revised Eysenck Personality Questionnaire). Assessment of impulsivity & stress were done by using the Barratt Impulsiveness Scale (BIS-11) & the Hassles and Uplifts Scale (HUS), respectively. Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) & the Positive and Negative Syndrome Scale (PANSS) were applied to determine the symptom severity in those diagnosed with depressive, anxiety & psychotic disorders.

Results: Suicidal ideations & attempts were more common among psychiatric patients especially those suffering from depression. Suicidal behavior was associated with increased severity of depressive & anxiety symptoms. The most common method of suicidal attempts among females was drug overdose, while males used self-poisoning as the most popular method in attempting suicide. Risk of suicidal ideation & attempts increased in the following situations: younger age groups especially below 35 years, female gender, substance abuse, low socioeconomic level, past history & family history of suicidal behavior, neuroticism, psychoticism & introversion personality traits, impulsivity, high daily stress levels, increase in the severity of depressive & anxiety disorders, elevated [ESR, Hs-CRP & IL-6], lowered [total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) & triglycerides (TG)]. The following factors protected from suicidal behaviors: marriage, work and having jobs, Family and social support, playing sports, having hobbies & higher socioeconomic levels.

Risk factors for transition of participants from suicidal ideation to suicidal attempt included female gender, being unmarried & unemployed, low socioeconomic level, poor social support, past history of suicidal behavior, neuroticism personality traits, impulsivity, high stress levels, depressive disorders, elevated [Hs-CRP & IL-6], and low [TC, LDL & TG]. Protective factors against transition from suicidal ideation to attempt included playing sports & extraversion personality traits.

Conclusion: The problem of suicide is a frequent and a multifaceted problem among the general population.