Association of clinical correlates, metabolic parameters, and thyroid hormones with suicide attempts in first-episode and drug-naïve adolescent depression comorbid with anxiety: a large-scale cross-sectional study

Abstract Background The prevalence of youth depression is rising, making the identification of reliable biomarkers for early detection increasingly challenging. This study explores potential biomarkers in youth experiencing their first depressive episode, with comorbid anxiety, and metabolic or thyroid imbalances. Methods We recruited 399 participants and measured thyroid stimulating hormone (TSH), triiodothyronine (FT3), free thyroxine (FT4), fasting blood glucose (FBG), cholesterol levels, body mass index (BMI), and blood pressure. Results Participants with abnormal TSH levels exhibited longer durations of depression, higher rates of suicidal behavior, increased anxiety, and more severe psychotic symptoms. Significant differences were observed in FBG, cholesterol levels, blood pressure, and BMI. Suicidal behavior was associated with higher TSH levels, anti-thyroglobulin antibodies (A-TG), and total cholesterol (TC), as well as lower high-density lipoprotein cholesterol (HDL-C) and BMI. Conclusions Our findings indicate a higher incidence of suicidal behaviors in youth with major depressive disorder (MDD) and comorbid anxiety symptoms. Elevated TSH levels, abnormal TC and HDL-C levels, and metabolic dysfunctions are significant risk factors. These findings underscore the importance of monitoring these biomarkers in managing youth with MDD.