Beyazıt Garip, Öykü İnanç
Neuropsychiatric Investigation - 2025;63(1):1-6
Objective: Antisocial personality disorder (ASPD) is associated with a heightened risk of suicide, particularly among male patients, where chosen suicide methods tend to be more lethal. The link between suicidal behavior and plasma testosterone levels remains a key area of investigation. This study investigates whether plasma testosterone levels differ between ASPD patients with a history of suicide attempts, aiming to explore the hormone's potential role as a biomarker for suicide risk. This study aimed to explore the association between plasma testosterone levels and suicidal behavior in individuals with ASPD who attempted suicide. Methods: A total of 44 patients with ASPD and 24 healthy controls were enrolled, matched by age, education, and gender. Biochemical evaluations included total and free testosterone, thyroid function tests, blood lipids, folate, ferritin, and vitamin B12 levels. Psychopathological assessments were conducted using the Hamilton Depression (HAM-D) and Anxiety (HAM-A) Scales. Results: The mean ages of the patient and control groups were 22.26 (+/-3.04) and 24.36 (+/-2.5) years, respectively. Free testosterone levels were significantly elevated in the patient group compared to controls (P = .02). Hamilton Anxiety (HAM-A) and HAM-D scores were also notably higher in the patient group. A positive correlation was identified between free testosterone levels and high-density lipoprotein in patients with ASPD (R = 0.520; P < .05). Conclusion: These preliminary findings suggest that elevated free testosterone may contribute to increased suicide risk in men with ASPD, potentially through its impact on impulsivity and aggression. While the effect size was modest, identifying hormonal patterns associated with suicidal behavior may help guide future risk assessment strategies. Further research with larger and more diverse samples is warranted.
