Associations between suicidal ideation and childhood maltreatment as well as inflammatory cytokines in adolescents with major depressive disorder.

Background: Suicidal ideation (SI) is thought to be associated with childhood maltreatment (CM) and inflammatory processes. Yet, these links are not thoroughly studied in adolescents with major depressive disorder (MDD). So, this study focused on investigating the predictive value of CM and inflammatory cytokines for SI in this population.

Methods: This study included 156 depressed adolescents. The Center for Epidemiological Studies Depression Scale (CES-D), the Childhood Trauma Questionnaire (CTQ) and the Positive and Negative Suicidal Ideation Scale (PANSI) were used to assess depression, CM and SI, respectively. Additionally, plasma inflammatory cytokines levels were measured, including interleukin (IL)-1β, IL-6, IL-10, IL-17A and tumor necrosis factor-α (TNF-α).

Results: Univariate analyses showed that females had higher levels of SI in adolescents with MDD. Moreover, the level of SI was negatively correlated with age and age at onset, and positively correlated with duration of illness, CES-D score, CTQ score, as well as levels of IL-1β, IL-6 and TNF-α (all p < 0.05). Furthermore, regression analyses revealed that SI was independently associated with age at onset, CES-D score, CTQ score, and Log IL-1β (all p < 0.05). Finally, receiver operating characteristic (ROC) curve analyses revealed that the combination of the CES-D score, CTQ score, and IL-1β (AUC = 0.910, 95% CI = 0.864-0.956, p < 0.001) had a better ability to identify SI in adolescents with MDD, exhibiting higher sensitivity and specificity.

Conclusion: SI is associated with depressive symptoms, CM and elevated levels of inflammatory cytokines (especially IL-1β) in adolescents with MDD. In the future, interventions such as cognitive behavioural therapy and the administration of anti-inflammatory drugs, targeting the modulation of CM and inflammatory cytokine levels, may play important roles in preventing suicidal behaviors in depressed adolescents.