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Examination of pain threshold and neuropeptides in patients with acute suicide risk.

  • Kim, Diane J1
  • Blossom, Sarah J2
  • Delgado, Pedro L3
  • Carbajal, Jessica M1
  • Cáceda, Ricardo4
  • 1 Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, New York, USA.
  • 2 Department of Pediatrics and Microbiology/Immunology, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, AR, USA.
  • 3 Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
  • 4 Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, New York, USA. Electronic address: [email protected]
Published Article
Progress in neuro-psychopharmacology & biological psychiatry
Publication Date
Dec 20, 2019
DOI: 10.1016/j.pnpbp.2019.109705
PMID: 31326514


One of the main challenges in suicide prevention is the limited understanding of the biological mechanisms underlying suicide. Recent findings suggest impairments in pain processing in acutely suicidal patients. However, little is known about the biological factors that may drive these discrete physiological abnormalities. In this study, we examined plasma peptides involved in analgesic and inflammatory responses and physical pain threshold in acutely suicidal patients. Thirty-seven depressed patients of both sexes hospitalized for severe suicidal ideation or a recent suicide attempt were characterized clinically including history of suicidal ideation and behavior. Psychological and physical pain, and pressure pain threshold was also measured. Plasma levels of β-endorphin, neurotensin, agouti-related protein (AgRP), C-reactive protein (CRP), adrenocorticotropic hormone (ACTH), and brain-derived neurotrophic factor (BDNF) were run in Milliplex multiplex assays. The number of lifetime suicide attempts was positively correlated with β-endorphin (r = 0.702; p = 0.007), and neurotensin (r = 0.728, p = 0.007) plasma levels. Higher pain threshold was measured in the suicide attempt group as compared to the suicidal ideation group. Pain threshold was strongly and negatively associated with CRP plasma levels (r = -0.548; p < 0.001). In patients reporting chronic pain, lower AgRP levels and lower pain threshold were observed (t = 4.472; p = 0.001). Our results suggest that abnormalities in the opioid and neurotensin systems may underlie the increase in pain threshold found in suicide attempters, and possibly risk for suicidal behavior. Targeting pain circuits and systems may provide therapeutic mechanisms for suicide prevention. Published by Elsevier Inc.

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