Childhood physical neglect and lower peripheral inflammatory indices in hospitalized male patients with substance use disorder: Associations with lifetime suicide attempts

Abstract

Objective: Childhood trauma is a major risk factor for suicidality and long-term biological stress alterations. Although suicidal behavior is commonly linked to systemic inflammation, it may also be associated with attenuated peripheral inflammatory responses. This study examined associations between childhood trauma subtypes, hemogram-derived inflammatory indices, and lifetime suicide attempts in hospitalized male patients with substance use disorder (SUD). Methods: Childhood trauma, hemogram-derived inflammatory indices—including monocyte-to-lymphocyte ratio (MLR) and systemic inflammation response index (SIRI)—a composite Cumulative Inflammation Score (CIS), and lifetime suicide attempts were assessed in 186 hospitalized men with SUD. Hierarchical multiple linear regression analyses were performed after adjustment for relevant clinical covariates. Results: Fifty-three patients (28.5%) had a history of suicide attempts and showed lower inflammatory indices (CIS: p = .006; MLR: p = .001). Physical neglect emerged as the trauma subtype most consistently associated with lower inflammation. In adjusted models, higher physical neglect scores remained independently associated with lower CIS (β = −.258, p = .007), MLR (β = −.248, p = .013), and SIRI (β = −.252, p = .009). These associations persisted after excluding hepatitis-positive participants. Conclusion: Childhood physical neglect may be associated with relatively lower peripheral inflammatory indices in hospitalized men with SUD, highlighting heterogeneity in inflammatory profiles within this population. Because the underlying mechanisms were not directly examined and the regression models explained only modest variance, these findings should be considered hypothesis-generating. Prospective longitudinal studies are needed to determine whether hemogram-derived inflammatory indices have clinical utility for understanding suicidality in SUD.