Prediction of Suicidality According to Serum Folate Levels in Depressive Patients Receiving Stepwise Pharmacotherapy

Background: The effects of serum folate levels on suicidal behavior, strongly associated with depression, have not been investigated. Therefore, this study investigated the associations between serum folate levels and suicidal behavior in patients with depressive disorders.Methods: Serum folate leve...

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Autores principales:	Jae-Min Kim, Ha-Yeon Kim, Hee-Joon Lee, Ju-Wan Kim, Hee-Ju Kang, Sung-Wan Kim, Il-Seon Shin, Byeong Jo Chun, Robert Stewart
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	folate suicidality prediction depression pharmacotherapy Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/96ae659e08304fd2bc5c19c0a7760b03
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spelling	oai:doaj.org-article:96ae659e08304fd2bc5c19c0a7760b032021-12-02T10:38:04ZPrediction of Suicidality According to Serum Folate Levels in Depressive Patients Receiving Stepwise Pharmacotherapy1664-064010.3389/fpsyt.2021.747228https://doaj.org/article/96ae659e08304fd2bc5c19c0a7760b032021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.747228/fullhttps://doaj.org/toc/1664-0640Background: The effects of serum folate levels on suicidal behavior, strongly associated with depression, have not been investigated. Therefore, this study investigated the associations between serum folate levels and suicidal behavior in patients with depressive disorders.Methods: Serum folate levels were measured at baseline in 1,094 patients with depressive disorder, 884 of whom were followed during a 12-month period of stepwise pharmacotherapy. Suicidal behaviors evaluated at baseline were (i) previous suicide attempt and (ii) baseline suicidal severity; behaviors evaluated at follow-up were (iii) increased suicidal severity and iv) fatal/non-fatal suicide attempt. Associations of serum folate levels with four types of suicidal behaviors were analyzed using logistic regression models after adjustment for relevant covariates; they were also examined using area under receiver operating characteristic (AUROC) curve analyses.Results: Reduced serum folate levels (<6.0 ng/mL) were independently associated with all four types of suicidal behaviors. AUROC curve analyses indicated that discriminant or prognostic values of reduced serum folate levels were fair for fatal/non-fatal suicide attempt during follow-up, whereas they were modest for previous suicide attempt, baseline suicidal severity, and increased suicidal severity.Conclusions: Serum folate levels could serve as a biomarker of suicidal behavior in depressive patients. However, it should be used as an adjunct rather than a substitute for prediction of suicidal behavior considering its low prognostic values. Further replication studies are needed for its clinical utilization.Jae-Min KimHa-Yeon KimHee-Joon LeeJu-Wan KimHee-Ju KangSung-Wan KimIl-Seon ShinByeong Jo ChunRobert StewartRobert StewartFrontiers Media S.A.articlefolatesuicidalitypredictiondepressionpharmacotherapyPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	folate suicidality prediction depression pharmacotherapy Psychiatry RC435-571
spellingShingle	folate suicidality prediction depression pharmacotherapy Psychiatry RC435-571 Jae-Min Kim Ha-Yeon Kim Hee-Joon Lee Ju-Wan Kim Hee-Ju Kang Sung-Wan Kim Il-Seon Shin Byeong Jo Chun Robert Stewart Robert Stewart Prediction of Suicidality According to Serum Folate Levels in Depressive Patients Receiving Stepwise Pharmacotherapy
description	Background: The effects of serum folate levels on suicidal behavior, strongly associated with depression, have not been investigated. Therefore, this study investigated the associations between serum folate levels and suicidal behavior in patients with depressive disorders.Methods: Serum folate levels were measured at baseline in 1,094 patients with depressive disorder, 884 of whom were followed during a 12-month period of stepwise pharmacotherapy. Suicidal behaviors evaluated at baseline were (i) previous suicide attempt and (ii) baseline suicidal severity; behaviors evaluated at follow-up were (iii) increased suicidal severity and iv) fatal/non-fatal suicide attempt. Associations of serum folate levels with four types of suicidal behaviors were analyzed using logistic regression models after adjustment for relevant covariates; they were also examined using area under receiver operating characteristic (AUROC) curve analyses.Results: Reduced serum folate levels (<6.0 ng/mL) were independently associated with all four types of suicidal behaviors. AUROC curve analyses indicated that discriminant or prognostic values of reduced serum folate levels were fair for fatal/non-fatal suicide attempt during follow-up, whereas they were modest for previous suicide attempt, baseline suicidal severity, and increased suicidal severity.Conclusions: Serum folate levels could serve as a biomarker of suicidal behavior in depressive patients. However, it should be used as an adjunct rather than a substitute for prediction of suicidal behavior considering its low prognostic values. Further replication studies are needed for its clinical utilization.
format	article
author	Jae-Min Kim Ha-Yeon Kim Hee-Joon Lee Ju-Wan Kim Hee-Ju Kang Sung-Wan Kim Il-Seon Shin Byeong Jo Chun Robert Stewart Robert Stewart
author_facet	Jae-Min Kim Ha-Yeon Kim Hee-Joon Lee Ju-Wan Kim Hee-Ju Kang Sung-Wan Kim Il-Seon Shin Byeong Jo Chun Robert Stewart Robert Stewart
author_sort	Jae-Min Kim
title	Prediction of Suicidality According to Serum Folate Levels in Depressive Patients Receiving Stepwise Pharmacotherapy
title_short	Prediction of Suicidality According to Serum Folate Levels in Depressive Patients Receiving Stepwise Pharmacotherapy
title_full	Prediction of Suicidality According to Serum Folate Levels in Depressive Patients Receiving Stepwise Pharmacotherapy
title_fullStr	Prediction of Suicidality According to Serum Folate Levels in Depressive Patients Receiving Stepwise Pharmacotherapy
title_full_unstemmed	Prediction of Suicidality According to Serum Folate Levels in Depressive Patients Receiving Stepwise Pharmacotherapy
title_sort	prediction of suicidality according to serum folate levels in depressive patients receiving stepwise pharmacotherapy
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/96ae659e08304fd2bc5c19c0a7760b03
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Prediction of Suicidality According to Serum Folate Levels in Depressive Patients Receiving Stepwise Pharmacotherapy

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