Suicide

A Surprising New Suicide Risk Factor: Grip Strength

Mechanisms such as inflammation or even self-esteem may be in play.

Posted Mar 09, 2021 |

  • Greater handgrip strength was associated with lower odds of having suicidal thoughts in a recent study.
  • The study, based on data from thousands of people in South Korea, echoes an earlier finding in American men.
  • While the reason for the relationship between grip strength and suicidal ideation is unclear, potential factors include increased inflammation and functional decline and disability.

An article by Hwang and Ahn, published in the January 2021 issue of the Journal of Affective Disorders, suggests that handgrip strength is associated with suicidal ideation.

Established Suicide Risk Factors

Suicide has been the subject of much research, and we already know a great deal about suicide.  

HolgersFotografie/Pixabay
Source: HolgersFotografie/Pixabay

For example, we know about geographical differences in suicide rates: While the annual age-standardized suicide rate is 10.5 per 100,000 individuals, suicide rates differ by country, being several times higher than the average in some places (e.g., Guyana, Russia, Lithuania, Kazakhstan).

In addition, we have identified when suicide is more likely to occur, in terms of the time of the day (peaking in the afternoons), week (early in the week), month (first week of the month), and season (spring and summer).

Furthermore, we know quite a few risk factors for suicide. For instance, for adults between the ages of 20 and 64 years, static risk factors for suicide include male gender, Caucasian ethnicity, low education, family history of suicide, personal history of suicide attempts, nonsuicidal self-injury, psychiatric diagnosis, physical or sexual abuse, arrests, and military duty.

Fluctuating or dynamic risk factors for suicide include marital status (single, divorced, widowed), current mental illness (especially depression), mental health symptoms (hopelessness, agitation, impulsivity, and sleeplessness), present conflict in the individual’s romantic relationship, recent arrest, job loss or financial distress, access to weapons, and certain factors related to military service (e.g., lower rank, substance use) and psychiatric hospitalizations (e.g., self-harm while in the hospital, recent discharge).

What other risk factors for suicide might there be? For a surprising answer, let us review the study by Ahn and Hwang.

Investigating the Link Between Handgrip Strength and Suicidal Ideation

The authors analyzed data from a sample of 14,325 individuals (average age of 50 years; 45 percent male) from a nationally representative survey in South Korea.

Suicidal ideation and depression were assessed with the following two questions: “Have you ever thought about committing suicide within the last 12 months?” And, “Have you ever felt sadness or despair continuously for more than two weeks during the past year?”

In general, depression and suicidal ideation were more common in females, older participants, individuals with comorbid conditions and an unhealthy lifestyle, and those with a lower socioeconomic status.

Handgrip strength—defined as the “maximally measured grip strength from the dominant hand”—was assessed using a digital grip strength dynamometer.

Multivariate logistic regression models were used to evaluate the link between grip strength and suicidal ideation.

Regression models showed lower handgrip strength correlated significantly with suicidal ideation in both sexes. As the researchers write, “for every 1 kg increase in handgrip strength, the odds of having suicidal thoughts decreased by 4 percent in males and 3 percent in females. This relationship held after adjusting for depressive mood.”

The correlation between suicidal ideation and handgrip strength is supported by previous research. For instance, in a sample of American men, “Each 5 kg increase in handgrip strength was associated with a 16 percent reduced odds of having suicidal thoughts.”

In the current investigation, the relationship between handgrip strength and suicidal ideation remained even after controlling for depression. Why? Perhaps suicidal thoughts are more specifically linked with hopelessness or lack of purpose in life (as opposed to depression). Indeed, a previous investigation in older adults found, “Purpose in life was prospectively associated with a decreased risk of developing weak grip strength.”

Let us now consider mechanisms linking handgrip strength and suicidal ideation.

Geralt/Pixabay
Source: Geralt/Pixabay

Why Is Grip Strength Related to Suicidal Thoughts?

One potential explanation for the link between handgrip strength and suicide is that reduced handgrip strength—and more generally, reduced muscle strength—is due to increased inflammation. And inflammation is increased in individuals with depression, particularly those with higher suicidal ideation.

Alternatively, the link between grip strength and suicide might be related to self-esteem. How? Given that being muscular is linked with higher self-esteem in men, lower muscle mass may be related to lower self-esteem and higher suicidal thoughts.

A related possibility is that those with lower muscle mass experience more functional decline and disability (e.g., needing more help with self-care and activities of daily living), which may negatively influence their mental health and self-esteem. Supporting this view, in a subgroup analysis in the present study, the link between suicidal thoughts and grip strength remained robust only in older men.

More research is needed to determine which of these mechanisms (and others) better explains the link between grip strength and suicide ideation.

What This Means for People at Risk

Weaker handgrip strength appears to be a risk factor for suicidal ideation. Future research needs to examine whether weak handgrip strength is also a risk factor for suicide attempts and death by suicide. If grip strength can be used as a reliable way to predict suicidal thoughts and suicide attempts, it might be a quick and easy way to screen for suicide risk.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 contact the National Suicide Prevention Lifeline, 1-800-273-TALK, or the Crisis Text Line by texting TALK to 741741. To find a therapist near you, see the Psychology Today Therapy Directory.