Elevated CSF CRF in suicide victims

Abstract

Introduction It has been suggested that several indices of enhanced hypothalamic-pituitary-adrenal axis activity, including dexamethasone nonsuppression, may be indicators of suicidal tendencies. However, recent studies have failed to prove that the Dexamethasone Suppression Test (DST) could be a predictor of suicidal behavior (Dam et al. 1985; Ennis et al. 1985; Kocsis et al. 1986; Secunda et al. 1986; Arato et al. 1986a; Modestin and Ruef 1987). Encouraged by a recent study of Stanley et al. (1985), we resorted to postmortem cerebrospinal fluid postmortem (CSF) analyses as a new research tool in the investigation of completed suicides (Arato et al. 1986b). We found no differences in CSF cortisol and adrenocorticotrophic hormone (ACTH) in suicides and controls. We now report on an extension of that investigation, involving measurement of the concentration of immunoreactive corticotropinreleasing factor (CRF) in CSF. It is quite plausible that excessive, long-lasting and/or uncontrollable stress could lead to a breakdown of the psychological defensive mechanisms and to the suicidal act. In that case,