Stress-related salivary biomarkers - cortisol, dehydroepiandrosterone, alpha amylase, and suicidal ideation among young women living in Kampala's informal settlements.
Aug 2026· Social Psychiatry and Psychiatric Epidemiology· 0 citations· 61 references
Medicine
TL;DR
Suicidal ideation was common, and square root-transformed morning cortisol-to-DHEA ratios were independently associated with suicidal ideation, and these findings highlight the importance of understanding suicidality through integrated biological, psychological, and social perspectives.
Abstract
Background
Young women living in informal urban settlements experience intersecting structural disadvantages that may contribute to stress-related physiological changes and suicidal ideation. Evidence on salivary stress biomarkers in this population remains limited.
Objective
To examine associations between salivary cortisol, dehydroepiandrosterone (DHEA), α-amylase, the cortisol-to-DHEA ratio, and suicidal ideation among young women in Kampala's informal settlements.
Methods
This cross-sectional analysis included 300 women aged 18-24 years recruited from three informal settlements in Kampala, Uganda. Suicidal ideation was assessed using four items from the Columbia-Suicide Severity Rating Scale. Morning and afternoon salivary biomarkers were measured using COBAS E411 and C-111 analyzers. Independent-samples t-tests compared biomarker levels by suicidal ideation status, and modified Poisson regression examined adjusted associations. The final model was used to estimate the prevalence ratio (PR) and its 95% confidence interval (CI).
Results
Overall, 46.0% reported suicidal ideation and 57.7% met the threshold for probable depression. Approximately 39% had DHEA values below published reference ranges at both collection times. Participants reporting suicidal ideation had lower square root-transformed morning DHEA levels than those without ideation (3.96 vs. 4.65; p = 0.048) and higher square root-transformed morning cortisol-to-DHEA ratios (1.19 vs. 1.00; p = 0.027). In the adjusted model, each one-unit increase in the square root-transformed morning cortisol-to-DHEA ratio was associated with a 12% higher prevalence of suicidal ideation (PR = 1.12; 95% CI: 1.04-1.21).
Conclusion
Suicidal ideation was common, and square root-transformed morning cortisol-to-DHEA ratios were independently associated with suicidal ideation. These findings highlight the importance of understanding suicidality through integrated biological, psychological, and social perspectives and reinforce the need for accessible, gender-responsive suicide prevention and mental health services in low-resource urban settings.
A single afternoon salivary cortisol measurement was not associated with same-day state anxiety in community-dwelling older adults in Japan during the COVID-19 pandemic, and this null finding should be interpreted in the context of the present study design and measurement approach.
Objective This study examines longitudinal associations among suicidal ideation, perceived social support, well-being, and depressive symptoms, and compares them across age groups and sex. Methods Participants (N = 1,078; aged 15–49 years) completed online questionnaires in January 2024 (T1) and February 2024 (T2), over a one-month interval. Suicidal ideation was assessed using the short form of the Scale for Suicide Ideation, perceived social support using the Multidimensional Scale of Perceived Social Support, depressive symptoms using the Patient Health Questionnaire-9, and well-being using the PERMA-Profiler. Using a latent change model, we estimated baseline levels (“Level”) and latent T1–T2 changes (“Change”) in suicidal ideation, mental health (well-being and depressive symptoms), and perceived social support. Here, “change in suicidal ideation” refers to latent short-term change from T1 to T2 and may reflect emergence, worsening, or improvement. Participants were divided into four groups by age and sex (younger women, younger men, middle-aged women, and middle-aged men), and multi-group analyses compared associations across groups. Younger and middle-aged participants were aged 15–29 and 30–49 years, respectively. Results Associations among the latent change factors (i.e., Change–Change correlations) differed by group. Among younger women, worsening suicidal ideation covaried with worsening depressive symptoms (r = 0.62, p < 0.001) and declines in well-being (r = −0.59, p < 0.001) and perceived social support (r = −0.37, p < 0.001). In contrast, Change–Change correlations among younger men were not significant. Among middle-aged women, worsening suicidal ideation covaried with declines in perceived social support (r = −0.21, p = 0.026) and well-being (r = −0.21, p = 0.023). Among middle-aged men, worsening suicidal ideation covaried with worsening depressive symptoms (r = 0.41, p < 0.001) and declines in perceived social support (r = −0.29, p = 0.003). Discussion Overall, perceived social support was associated with lower short-term change in suicidal ideation in all groups except younger men, suggesting that social support may be a relevant correlate of short-term co-change in suicidal ideation. Particularly among younger women, short-term changes in well-being and depressive symptoms may be especially important correlates of suicidal ideation, whereas correlates of short-term change in suicidal ideation may differ among younger men.
Ayumi Fusejima, Azusa Arimoto, Kenkichi Takase et al.· Frontiers in Psychology· 0 citations
Background Suicidality is a critical public health concern among LGBTQ+ youth, yet evidence from Vietnam remains limited. This study estimated the prevalence of suicidal ideation, plans, and attempts and examined associated sociodemographic and psychological factors among Vietnamese LGBTQ+ youth. Methods We conducted a community-based, online cross-sectional survey from February to April 2025. Participants included 384 LGBTQ+ individuals aged 18–24 years residing in Vietnam. Participants were recruited through the LGBTQ+ -led or LGBTQ+ -supportive social media and community networks. Suicidality was assessed alongside symptoms of depression, anxiety, and stress using the Depression Anxiety Stress Scales (DASS-21). Monthly income was self-reported and categorized into USD bands. Multivariable logistic regression models were employed to identify factors associated with lifetime suicidal outcomes. Results The lifetime prevalence of suicidal ideation, plans, and attempts was 56.5%, 32.1%, and 16.9%, respectively. Recent (past 12 months) prevalence was 5.5%, 3.6%, and 3.1%. In multivariable analyses, stress [AOR = 4.52 (95% CI: 2.35–8.72)] and anxiety [AOR = 2.12 (95% CI: 1.03–4.34)] were associated with higher odds of suicidal ideation and plans. Anxiety emerged as the sole independent predictor of suicide attempts [AOR = 4.30 (95% CI: 1.28–14.41)]. Conversely, higher income (≥USD 386/month) and rural residence were associated with lower odds of suicidal ideation. Conclusions Suicidality is highly prevalent among this accessible, predominantly urban, and connected subpopulation of LGBTQ+ youth in Vietnam. Anxiety and stress are the most robust proximal correlates of suicidal behaviors. Suicide prevention strategies for this population must incorporate routine screening for anxiety and stress, deliver LGBTQ + -affirming care, and address underlying economic vulnerabilities.
M. Do, Tung Doan, M. Pham et al.· PLoS ONE· 0 citations
BACKGROUND
This study aimed to examine the association between irregular meal timing and symptoms of depression, anxiety, and stress among Iranian adults.
METHODS
This cross-sectional study included 450 apparently healthy adults (aged 20-59 years; 53.8% female) recruited via convenience sampling. Dietary data were collected using three non-consecutive 24-h recalls to assess meal timing irregularity, defined as day-to-day variability and deviation from participants' habitual meal timing, using composite phase deviation (CPD) scores for breakfast, lunch, and dinner. Mental health outcomes were measured with the Depression Anxiety Stress Scales short form. Covariates included sleep quality (Pittsburgh Sleep Quality Index), chronotype (Morningness-Eveningness Questionnaire), physical activity (International Physical Activity Questionnaire), anthropometrics, and sociodemographics. Associations were examined using multivariable logistic regression for binary outcomes and linear regression for continuous scores, adjusting for confounders. Linear regression analyses included participants with complete data for all model variables (n = 404).
RESULTS
No significant associations emerged between meal timing irregularity tertiles and binary mental health outcomes (all adjusted P-trend>0.05). However, in linear regression models, dinner irregularity was independently associated with higher depressive symptom scores (B = 1.08, 95% CI 0.32-1.85, P = 0.006), but not stress (P = 0.336) and anxiety (P = 0.388). Breakfast and lunch irregularities showed no significant associations.
CONCLUSIONS
Dinner timing irregularity may be associated with higher depressive symptom scores in this sample of Iranian adults. Future prospective and intervention studies are needed to clarify temporality and underlying mechanisms.
Vida Dankoob, Amirreza Ostevari, Bahareh Jabbarzadeh Ganji et al.· Journal of Affective Disorde...· 0 citations
Perceived stress showed the strongest association with both anxiety and somatic symptom burden, and the use of a single total activity score concealed a more specific inverse association between vigorous leisure-time activity and somatic symptoms.
Mihaela Fadgyas Stanculete, O. Căpățînă, Catalin Alexandru Chihaia· Medicina· 0 citations
Nonlinear interactions between cortisol indices and daily stressor severity appear to predict 9-year alcohol use disorder and substance use disorder severity, with cortisol area under the curve emerging as the most robust indicator.
N. Zainal, Natalia Van Doren· Addiction· 0 citations
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