Prospective Associations of Serum Tumor Necrosis Factor-Alpha and Employment on Suicidal Behaviors Over 1 Year in Depressive Patients Receiving Psychopharmacotherapy

OBJECTIVE: This study explored both the individual and combined effects of serum tumor necrosis factor-alpha (sTNF-α) levels and employment status on suicidal behavior (SB) in patients with depressive disorders undergoing pharmacologic treatment. METHODS: Baseline measurements of sTNF-α levels were taken, and employment status was determined. Over a 1-year period of stepwise pharmacotherapy, SB was monitored and categorized into increased suicidal severity and fatal/non-fatal suicide attempts. Logistic regression models adjusted for relevant covariates were used to analyze the individual and interactive associations between sTNF-α levels, employment status, and these two forms of SB. RESULTS: Unemployment was significantly associated with both forms of SB, whereas sTNF-α levels alone did not show a significant correlation. However, lower sTNF-α levels combined with employment were associated with the lowest incidence rates of both SB categories, demonstrating significant interactive effects after adjustment. CONCLUSION: The study demonstrates that the prospective associations of sTNF-α levels for SB is enhanced when combined with employment status in patients receiving pharmacological treatment for depressive disorders. These findings suggest that integrating biological markers with socio-economic factors can improve the assessment and management of suicide risk.