High testosterone levels associated with elevated suicidal risk in male adolescents with depression

Abstract Background Adolescent suicide, as a public health issue, is becoming increasingly urgent, yet there remains a lack of effective objective biomarkers for identifying high-risk adolescents. While testosterone has been linked to suicide, no definitive conclusions have been reached. Studies in...

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Main Authors: Han Wang, Nan Lyu, Juan Huang, Bingbing Fu, Lili Shang, Fan Yang, Ling Zhang, Qian Zhao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-07098-3
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author Han Wang
Nan Lyu
Juan Huang
Bingbing Fu
Lili Shang
Fan Yang
Ling Zhang
Qian Zhao
author_facet Han Wang
Nan Lyu
Juan Huang
Bingbing Fu
Lili Shang
Fan Yang
Ling Zhang
Qian Zhao
author_sort Han Wang
collection DOAJ
description Abstract Background Adolescent suicide, as a public health issue, is becoming increasingly urgent, yet there remains a lack of effective objective biomarkers for identifying high-risk adolescents. While testosterone has been linked to suicide, no definitive conclusions have been reached. Studies in specific populations defined by significant changes in age or hormone levels and by gender have shown greater reproducibility. This study aims to investigate the association between testosterone levels and suicidal ideation or behavior in male and female adolescents with major depressive disorder (MDD). Methods This retrospective, cross-sectional study included 1227 adolescents with MDD, aged 10–19 years, hospitalized at the Beijing Anding Hospital, Capital Medical University, from January 2013 to December 2020. Patients were categorized into two groups: those with suicidal ideation or behavior (MDS) and those without (MDNS). Demographic data, clinical characteristics, and serum testosterone levels at admission were extracted and compared. An additional 579 adolescents meeting the same inclusion criteria were included for validation, with data collected from January 2022 to December 2023. Results In male adolescents, testosterone levels were significantly higher in the MDS group compared to the MDNS group(Z = -4.340, P < 0.001). After adjusting for confounding factors, testosterone levels remained significantly associated with suicidal ideation or behavior (OR = 1.220, 95% CI: 1.098–1.356). This finding was confirmed in the validation data set (OR = 1.444, 95% CI: 1.139–1.832). No significant difference in testosterone levels was observed in females (Z = 1.643, P = 0.100). Conclusions Elevated serum testosterone levels were independently associated with increased risk of suicidal ideation or behavior in male adolescents with MDD, but not in females. These findings highlight the necessity for sex-specific biomarkers, however, due to the intrinsic limitations of the current study, they necessitate further validation. Clinical trial number Not applicable.
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spelling doaj-art-5ed2fec9bd7647b49d5684be2dfd50302025-08-20T03:03:34ZengBMCBMC Psychiatry1471-244X2025-07-0125111010.1186/s12888-025-07098-3High testosterone levels associated with elevated suicidal risk in male adolescents with depressionHan Wang0Nan Lyu1Juan Huang2Bingbing Fu3Lili Shang4Fan Yang5Ling Zhang6Qian Zhao7Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical UniversityAbstract Background Adolescent suicide, as a public health issue, is becoming increasingly urgent, yet there remains a lack of effective objective biomarkers for identifying high-risk adolescents. While testosterone has been linked to suicide, no definitive conclusions have been reached. Studies in specific populations defined by significant changes in age or hormone levels and by gender have shown greater reproducibility. This study aims to investigate the association between testosterone levels and suicidal ideation or behavior in male and female adolescents with major depressive disorder (MDD). Methods This retrospective, cross-sectional study included 1227 adolescents with MDD, aged 10–19 years, hospitalized at the Beijing Anding Hospital, Capital Medical University, from January 2013 to December 2020. Patients were categorized into two groups: those with suicidal ideation or behavior (MDS) and those without (MDNS). Demographic data, clinical characteristics, and serum testosterone levels at admission were extracted and compared. An additional 579 adolescents meeting the same inclusion criteria were included for validation, with data collected from January 2022 to December 2023. Results In male adolescents, testosterone levels were significantly higher in the MDS group compared to the MDNS group(Z = -4.340, P < 0.001). After adjusting for confounding factors, testosterone levels remained significantly associated with suicidal ideation or behavior (OR = 1.220, 95% CI: 1.098–1.356). This finding was confirmed in the validation data set (OR = 1.444, 95% CI: 1.139–1.832). No significant difference in testosterone levels was observed in females (Z = 1.643, P = 0.100). Conclusions Elevated serum testosterone levels were independently associated with increased risk of suicidal ideation or behavior in male adolescents with MDD, but not in females. These findings highlight the necessity for sex-specific biomarkers, however, due to the intrinsic limitations of the current study, they necessitate further validation. Clinical trial number Not applicable.https://doi.org/10.1186/s12888-025-07098-3AdolescentDepressionSuicideMaleTestosterone
spellingShingle Han Wang
Nan Lyu
Juan Huang
Bingbing Fu
Lili Shang
Fan Yang
Ling Zhang
Qian Zhao
High testosterone levels associated with elevated suicidal risk in male adolescents with depression
BMC Psychiatry
Adolescent
Depression
Suicide
Male
Testosterone
title High testosterone levels associated with elevated suicidal risk in male adolescents with depression
title_full High testosterone levels associated with elevated suicidal risk in male adolescents with depression
title_fullStr High testosterone levels associated with elevated suicidal risk in male adolescents with depression
title_full_unstemmed High testosterone levels associated with elevated suicidal risk in male adolescents with depression
title_short High testosterone levels associated with elevated suicidal risk in male adolescents with depression
title_sort high testosterone levels associated with elevated suicidal risk in male adolescents with depression
topic Adolescent
Depression
Suicide
Male
Testosterone
url https://doi.org/10.1186/s12888-025-07098-3
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