Low plasma total testosterone (T) levels may influence the sense of
well-being and produce depressive symptomatology, increasing the risk of
suicide. In a previous study, we reported reduced serum T levels in male
psychiatric patients after a suicide attempt. The reduction was more
pronounced in subjects who used violent attempt methods, and we
discussed the possible influence of stress of hospitalization, serious
medical condition and treatment In order to minimize the influence of
such factors, we compared in this study the levels of plasma sex
hormones of 15 psychiatric patients (10 suffering from schizophrenia and
5 from depression) who had attempted suicide by jumping with those of a
group of 18 male subjects who were hospitalized after accidentally
falling from a high height. Compared with a healthy control group of 40
males, both accident and attempt groups had lower T levels. The attempt
group showed a trend toward lower T levels compared with levels in the
accident group. In the accident group, luteinizing hormone (LH) levels
were elevated compared with levels in healthy controls, indicating a
normal function of the hypothalamic-pituitary-gonadal (HPG) axis. This
was not the case for the attempt group, where low T levels were not
accompanied by increases in LH. Cortisol and prolactin were similarly
elevated in both patient groups, but were not related to the low T
levels. The results indicate that male psychiatric patients who attempt
suicide by violent methods may have low total plasma T levels, possibly
due to a dysfunction of the HPG axis at the hypothalamic-pituitary
level. Monitoring HPG axis function in future studies could prove to be
a predictor of suicide at least for male psychiatric attempters, and
could lead to preventive strategies. (c) 2008 Elsevier Ireland Ltd. All
rights reserved