Scientists at Indiana University may have found a new, more reliable way for doctors to predict if someone is considering suicide. The researchers, led by psychiatrist Alexander Niculescu, discovered detectable blood biomarkers for suicide risk. They published a report on their findings last week in the journal Molecular Psychiatry.
Niculescu says finding out if patients are suicidal could help doctors intervene and prevent many tragedies. Suicide is a growing public health problem. The most recent data shows more than 41,000 Americans kill themselves each year, making it the 10th most common cause of death.
“We think it's a preventable tragedy,” says Niculescu. “We set out to discover objective predictors that could help us identify who is at risk early on so we could potentially have those people be followed up more closely [and] be treated.”
But currently there’s no reliable way for doctors to predict a patient’s suicidality. This is because doctors depend on what a patient tells them, and patients aren’t usually forthcoming about their desire to kill themselves, explains Niculescu. “They don't want to be prevented from committing suicide,” he says. “So we need something that doesn't rely on the self report of the individual.”
In line with recent advances in psychiatric research, Niculescu and his team decided to look for detectable biological markers of the illness. When a person is sick, the body can undergo chemical changes that can be measured. For example, doctors look at resting glucose levels when testing for diabetes.
For suicide risk, the types of biomarkers Niculescu’s team honed in on are RNA molecules in the blood that reflect gene expression. The team enrolled more than 200 male psychiatric patients in their study. Of those, 37 expressed some change in their desire to live—either becoming suicidal during the course of the study, or going from suicidal to wanting to live. The scientists then compared RNA molecules in the patients’ blood to that of actual suicide victims to find relevant biomarkers.
The team’s biomarker test was 70 percent accurate in predicting the onset of suicidal thoughts or behaviors. Even better, the researchers got up to more than 90 percent accuracy when they combined the biomarker test with a questionnaire—administered as a smartphone app—assessing stress and other suicide risk factors.
Niculescu says this tool could be important for a doctor seeing a patient for the first time.
“Sometimes you don't have any information about the patient, you don't have time to get that information,” he says.
Niculescu and his team still have work to do to get the biomarker test into the hands of doctors. The results just published only included male psychiatric patients. The team is currently conducting a study with females that is still unpublished; Niculescu says the results are “encouraging.”
And right now, testing patients takes time—samples go to a lab in California—but they’re working on making it faster, so their approach could be used in an actual hospital or doctor’s office. The idea is to ultimately make screening for suicide risk as straight-forward as screening for other illnesses.
“These tools could be used in an acute setting to help with decision making, whether somebody could be released home or hospitalized and so on,” says Niculescu. “Just like we do cholesterol tests and other tests for cardiovascular risk factors, I think people should be screened for these mental health risk factors with apps, with blood tests.”
Ultimately, Nicolescu says the tools he’s developing could be used at different stages in someone’s treatment, but earlier you can intervene when someone is suicidal, the better it is.
“We're on a mission,” says Niculescu. “I think it's something that can change people's lives, [that can change] their trajectories, from something that can spiral out of control to having a normal productive life.”
Jake Harper can be reached at jharper@wfyi.org or 317-614-0482. Follow @jkhrpr.
