Key Points:
- A prior suicide attempt is the highest risk factor for suicide in the general population.
- A new study shows people with major depressive disorder and a history of attempted suicide have distinct biomarkers that correlate with their response to antidepressant therapy.
- The multi-omics approach of the study shed light on biological signatures that were previously undiscovered.
Researchers at the Mayo Clinic have discovered that people with major depressive disorder and a history of attempted suicide have distinct biomarkers that correlate with their response to antidepressant therapy. The findings could lead to personalized treatment strategies and early identification of patients who are at the highest risk for suicide.
For the study, published in Frontiers Pharmacology, the researchers used metabolomics and genomics to analyze samples from 350 patients with major depressive disorder. They found that variations in the genes CLOCK and ARNTL differentiate in patients with and without a prior suicide attempt. Both genes are related to the circadian rhythm, which regulates critical functions in the body, including behavior, metabolism, hormone levels and sleep. These specific gene variations are also associated with lower antidepressant response and remission rates.
“Evaluating suicidal patients can be challenging because clinical risk assessments are inherently subjective and major depressive disorder has high degrees of variability,” says Paul Croarkin, D.O., M.S., a psychiatrist at Mayo Clinic and senior investigator of the study. "Our study lays a foundation for advancing the prognostic potential of this disease and enhancing patient outcomes that use both biological and digital biomarkers."
The researchers said the multi-omics approach of their study was key. Individually, metabolomics and genomics each successfully reveal critical aspects of biological processes; but, analyzing them jointly has the potential to reveal under-studied interactions. In this case, by simultaneously evaluating the genome and metabolome, the research team discovered new biological signatures that could not be found by one or the other technique individually.
The study is part of ongoing efforts at Mayo Clinic to understand the biology of suicidality to improve diagnostic approaches, treatments, and outcomes for patients with depression and other mood disorders.
Information provided by Mayo Clinic.