Oxidative stress and lowered total antioxidant status are associated with a history of suicide attempts

J Affect Disord. 2013 Sep 25;150(3):923-30. doi: 10.1016/j.jad.2013.05.016. Epub 2013 Jul 12.


Background: There is evidence that depression is accompanied by inflammation, oxidative and nitrosative stress (O&NS) and metabolic disorders. However links between oxidative stress and suicide attempts in depressed patients are poorly understood. This study examines whether a history of suicide attempts is associated with inflammation, O&NS and metabolic disorders.

Methods: Blood specimens were collected from study participants aged 18-60 (N=342) recruited at the State University of Londrina, Brazil, and measured for oxidative stress biomarkers: nitric oxide metabolites (NOx), lipid hydroperoxides, malondialdehyde, advanced oxidation protein products and plasma total antioxidant potential (TRAP); inflammatory biomarkers: fibrinogen, high-sensitivity C-reactive protein, erythrocyte sedimentation rate, interleukin-6 and tumor necrosis factor-α; and metabolic variables. Subjects were divided into those with (n=141) and without (n=201) a history of suicidal attempts.

Results: Individuals with a history of suicide attempts had significantly higher levels of NOx and lipid hydroperoxides and lowered TRAP as compared to individuals without suicide attempts. There were no significant associations between a history of suicide attempts and inflammatory and metabolic biomarkers and metabolic syndrome. Logistic regression showed that both unipolar and bipolar disorder, female gender, smoking behavior and lipid hydroperoxides were significantly associated with a history of suicide attempts. The combined effects of oxidative stress, smoking, depression, female gender were independent from classical risk factors, including marital status, years of education and anxiety.

Conclusions: O&NS as well as lowered antioxidant levels may play a role in the pathophysiology of suicidal behavior independently from the effects of depression and smoking, both of which are associated with increased O&NS, and classical suicide predictors, such as years of education and marital status.

Keywords: Depressive disorders; Inflammation; Metabolism; Nicotine dependence; Oxidative stress; Suicide.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Brazil / epidemiology
  • C-Reactive Protein / analysis
  • Depression / blood
  • Female
  • Humans
  • Inflammation / blood
  • Interleukin-6 / blood
  • Logistic Models
  • Male
  • Metabolic Syndrome / blood
  • Middle Aged
  • Nitric Acid / blood
  • Oxidative Stress*
  • Risk Factors
  • Self Report
  • Smoking / blood
  • Suicide, Attempted*
  • Tumor Necrosis Factor-alpha / blood
  • Young Adult


  • Biomarkers
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Nitric Acid
  • C-Reactive Protein