A comparative study of inflammatory marker highly sensitive C- Reactive Protein in depression patients exhibiting suicidal behaviour and depression patients without suicidal behaviour


  • Varchasvi Mudgal Department of Psychiatry, M.G.M Medical College, Indore, Madhya Pradesh, India
  • V. S. Pal Department of Psychiatry, M.G.M Medical College, Indore, Madhya Pradesh, India
  • Pali Rastogi Department of Psychiatry, M.G.M Medical College, Indore, Madhya Pradesh, India
  • Rajeev Lohokare Department of Psychiatry, M.G.M Medical College, Indore, Madhya Pradesh, India




C-reactive protein, Inflammatory marker, Depression, Suicide


Background: Recent research have found a link between inflammatory pathway and suicidal behaviour. hs-CRP, IL, TNF have been shown to have significant alterations in suicidality, however multiple covariates influence this relationship. One of the main limitations of most of the studies is that they have evaluated the CRP in patients demonstrating suicidal behaviour but not in depression. No study has been conducted in Indian subpopulation with parameters of our study. Aims of the study was to compare hsCRP levels between depression patients with suicidal behaviour and without suicidal behaviour.

Methods: Authors compared 50 depression patients with suicidal behaviour and 50 depression patients without suicidal behaviour, diagnosed using ICD10. Hamilton Depression Rating Scale (HDRS‑17), Suicide behaviour Questionnaire- Revised (SBQ-R), Beck Scale for Suicidal Ideation (BSSI) were applied for assessment of depression and suicidality. Highly sensitive CRP was measured using autoanalyzer.

Results: hsCRP levels were significantly high in depression patients with suicidal behaviour (4.12 mg/dl) than depression without suicidal behaviour (2.42 mg/dl). Duration of illness, HAM-D, BSSI and SBQ-R scores correlated positively with hsCRP levels.

Conclusions: Depression with suicidal behaviour patients have a significantly higher hs-CRP levels than depression without suicidal behaviour. Patients of depression with suicidal behaviour group have a strong positive correlation between hs-CRP levels and HAM-D, BSSI and SBQ-R scores.


World Health Organisation. Fact sheet: Depression, 2019. Available at: https://www.who.int/news-room/fact-sheets/detail/depression. Accessed June 2019.

World Health Organisation. Fact sheet: Suicide, 2019. Available at: https://www.who.int/news-room/fact-sheets/detail/suicide. Accessed June 2019.

Pandey GN, Dwivedi Y. Peripheral Biomarkers for Suicide. In: Dwivedi Y, editor. The Neurobiological Basis of Suicide. Chapter 20. Boca Raton (FL): CRC Press/Taylor & Francis; 2012: 407.

Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Brit J Psychiatr. 1997 Mar 1;170(3):205-28.

Mann JJ. Neurobiology of suicidal behaviour. Nat Rev Neurosci.2003;4(10):819-28.

Bach H, Arango V. Neuroanatomy of serotonergic abnormalities in suicide. In: Dwivedi Y (ed) The neurobiological basis of suicide. Frontiers in neuroscience. Chapter 2. Boca Raton, CRC press; 2012: 11.

Courtet P, Jaussent I, Genty C, Dupuy AM, Guillaume S, Ducasse D, et al. Increased CRP levels may be a trait marker of suicidal attempt. Eur Neuropsychopharmacol. 2015 Oct;25(10):1824-31.

Gibbs HM, Davis L, Han X, Clothier J, Eads LA, Cáceda R.Association between C-reactive protein and suicidal behavior in an adult inpatient population. J Psychiatr Res. 2016 Aug;79:28-33.

Loas G, Dalleau E, Lecointe H, Yon V. Relationships between anhedonia, alexithymia, impulsivity, suicidal ideation, recent suicide attempt, C-reactive protein and serum lipid levels among 122 inpatients with mood or anxious disorders. Psychiatr Res. 2016 Dec 30;246:296-302.

Gambji F, De Berardis D, Campanella D, Carano A. A retrospective evaluation of the inflammatory marker c-reactive protein (CRP), cholesterol and high-density lipoproteins in patients with major depression: Preliminary findings. Europ J Inflammation. 2005;3(3):127-34.

Park RJ, Kim YH. Association between high sensitivity CRP and suicidal ideation in the Korean general population. Europ Neuropsychopharmacol. 2017 Sep 1;27(9):885-91.

World Health Organization. The ICD‑10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: World Health Organization; 1993:89‑103.

Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatr. 1960;23:56‑62.

Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the Scale for Suicide Ideation. J Consult Clini Psychol. 1979 Apr;47(2):343-52.

Osman A, Bagge CL, Gutierrez PM, Konick LC, Kopper BA, Barrios FX. The Suicidal Behaviors Questionnaire-Revised (SBQ-R): validation with clinical and nonclinical samples. Assessment. 2001 Dec;8(4):443-54.

Islam MR, Adnan R. Socio-Demographic Factors and Their Correlation with the Severity of Major Depressive Disorder: A Population Based Study. World J Neurosci. 2017;7(02):193-202.

Narang RL, Mishra BP, Nitesh M. Attempted suicide in Ludhiana. Ind J Psychiatr. 2000 Jan;42(1):83-7.

Chukwujekwu CD, Olose EO, Dariah GO, Okeafor CU. Socio Demographic Correlates of Depressed Patients Attending a Tertiary Hospital in Nigeria. J Addict Res Ther. 2017;8(313):2.

Musić Milanović S, Erjavec K, Poljičanin T, Vrabec B, Brečić P. Prevalence of depression symptoms and associated socio-demographic factors in primary health care patients. Psychiatria Danubina. 2015 Mar 9;27(1):31-7.

Agarwal A, Agarwal M, Garg K, Dalal PK, Trivedi JK, Srivastava JS. Metabolic syndrome and central obesity in depression: A cross-sectional study. Indian J Psychiatr. 2016;58:281-6.

Dar MM, Tarfarosh SF, Kullah SM, Mushtaq R, Manzoor M, Maqbool S. Socio-Demographic and Clinical Profile of Patients Suffering from Severe Depressive Disorders in Kashmir Valley. Age (years). 2016;21(30):14.

Solomon DA, Keller MB, Leon AC, Mueller TI, Shea MT, Warshaw M, et al. Recovery from major depression: a 10-year prospective follow-up across multiple episodes. Arch General Psychiatr. 1997 Nov 1;54(11):1001-6.

Park SC, Hahn SW, Hwang TY, Kim JM, Jun TY, Lee MS, et al. Does age at onset of first major depressive episode indicate the subtype of major depressive disorder?: the clinical research center for depression study. Yonsei Med J. 2014 Nov 1;55(6):1712-20.

Yang F, Li Y, Xie D, Shao C, Ren J, Wu W, et al. Age at onset of major depressive disorder in Han Chinese women: relationship with clinical features and family history. J Affec Disord. 2011;135:89-94.

Srivastava AS, Kumar R. Suicidal ideation and attempts in patients with major depression: Sociodemographic and clinical variables. Indian J Psychiatr. 2005;47:225-8.

Trivedi MH, Morris DW, Wisniewski SR, Nierenberg AA, Gaynes BN, Kurian BT, et al. Clinical and Sociodemographic Characteristics Associated With Suicidal Ideation in Depressed Outpatients. Can J Psychiatr. 2013;58(2):113-22.

Hawton K, i Comabella CC, Haw C, Saunders K. Risk factors for suicide in individuals with depression: a systematic review. J Affect Disord. 2013 May 1;147(1-3):17-28.

Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X, et al. Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychol Bull. 2017 Feb;143(2):187-232.

Coentre R, Faravelli C, Figueira ML. Assessment of depression and suicidal behaviour among medical students in Portugal. Int J Med Edu. 2016;7:354-63.

Chang CC, Tzeng NS, Kao YC, Yeh CB, Chang HA. The relationships of current suicidal ideation with inflammatory markers and heart rate variability in unmedicated patients with major depressive disorder. Psychiatr Res. 2017 Dec 1;258:449-56.

Batty GD, Bell S, Stamatakis E, Kivimäki M. Association of Systemic Inflammation With Risk of Completed Suicide in the General Population. JAMA Psychiatry. 2016;73(9):993-5.

Ma Y, Chiriboga DE, Pagoto SL, Rosal MC, Li W, Merriam PA, et al. Association between Depression and C-Reactive Protein. Preventive and Behavioral Medicine Publications.2011;2011

Addis M, Linehan MM. Predicting suicidal behavior: Psychometric properties of the Suicidal Behaviors Questionnaire. In Poster presented at the annual meeting of the Association for the Advancement of Behavior Therapy, Washington, DC 1989 Nov 2.




How to Cite

Mudgal, V., Pal, V. S., Rastogi, P., & Lohokare, R. (2020). A comparative study of inflammatory marker highly sensitive C- Reactive Protein in depression patients exhibiting suicidal behaviour and depression patients without suicidal behaviour. International Journal of Research in Medical Sciences, 8(3), 1086–1093. https://doi.org/10.18203/2320-6012.ijrms20200786



Original Research Articles