Even though women are three times more likely to attempt suicide than men, they are nearly four times less likely to die from it — likely because females attempt less violent means of killing themselves that are more likely to fail. Because they are more prone to psychological problems such as depression, women are thought to be at higher risk for suicide. New research published in the journal Molecular Psychiatry has identified measures that could predict which females being treated for these issues are most at risk.

Researchers at the Indiana School of Medicine have come up with ways to help clinicians identify which women have a greater risk of attempting suicide using blood tests and questionnaires that are personalized for women. The study follows similar research published last year by the same group  of researchers who identified blood-based biomarkers and questionnaires that could predict which men were most likely to begin thinking of suicide, or to attempt it.

"Women have not been adequately studied in research about suicide, and we did not know how well we would be able to define objective predictors of suicide in women,” Dr. Alexander Niculescu III, the study’s principal investigator, said in a statement. “It was important to determine whether biomarkers and app-based questionnaires could be used to make predictions among women, and whether such tests can be adjusted for gender to be more accurate.”

Niculescu and his colleagues collected data from 51 female patients who had been diagnosed with psychiatric disorders such as depression, bipolar disorder and schizophrenia. They took note of instances when the participants' sentiments alternated between no thoughts of suicide to high levels of suicide ideation. They identified 12 patients with these mood swings and conducted genomic analyses on them to identify genes with activity that were significantly different between the two states.

After identifying these potential blood-based biomarkers of increased suicide risk, they validated their results by comparing the genes to the blood samples — provided by the Marion County (Indianapolis, Ind.) Coroner's Office — of six women who had committed suicide. Fifty such biomarkers were validated.

Researchers also came up with two app-based questionnaires to assess a psychiatric patient’s risk of suicidal thoughts and attempts. Instead of flat-out asking whether the individual is having suicidal thoughts, the questionnaires measures their mood and anxiety, and asks them about life issues such as physical and mental health.

They recruited another group of women — 33 in total — with the same psychiatric diagnoses to test their findings by confirming that the blood-based biomarkers and apps predicted suicide ideation in women. Researchers also examined their ability to predict future hospitalizations for suicide attempts. The data showed that the biomarkers and apps predicted future instances of suicidal thoughts with 82 percent accuracy, and future suicide-associated hospitalizations with 78 percent accuracy.

Beyond the small size of the study, other limitations include the focus on those diagnosed with psychiatric illnesses. Niculescu notes that although the results are promising, it is not known how well the biomarkers would work among people who have not been diagnosed with a  psychiatric disorder.

Source: Levey D, Niculescu A, Niculescu E, et al. Towards Understanding and Predicting Suicidality in Women: Biomarkers and Clinical Risk Assessment. Nature . 2016.