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Evidence on salivary stress biomarkers in this population remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine associations between salivary cortisol, dehydroepiandrosterone (DHEA), \u03b1-amylase, the cortisol-to-DHEA ratio, and suicidal ideation among young women in Kampala\u2019s informal settlements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional analysis included 300 women aged 18\u201324 years recruited from three informal settlements in Kampala, Uganda. Suicidal ideation was assessed using four items from the Columbia\u2013Suicide Severity Rating Scale. Morning and afternoon salivary biomarkers were measured using COBAS E411 and C-111 analyzers. Independent-samples t-tests compared biomarker levels by suicidal ideation status, and modified Poisson regression examined adjusted associations. The final model was used to estimate the prevalence ratio (PR) and its 95% confidence interval (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 46.0% reported suicidal ideation and 57.7% met the threshold for probable depression. Approximately 39% had DHEA values below published reference ranges at both collection times. Participants reporting suicidal ideation had lower square root-transformed morning DHEA levels than those without ideation (3.96 vs. 4.65;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048) and higher square root-transformed morning cortisol-to-DHEA ratios (1.19 vs. 1.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027). In the adjusted model, each one-unit increase in the square root-transformed morning cortisol-to-DHEA ratio was associated with a 12% higher prevalence of suicidal ideation (PR\u2009=\u20091.12; 95% CI: 1.04\u20131.21).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Suicidal ideation was common, and square root-transformed morning cortisol-to-DHEA ratios were independently associated with suicidal ideation. These findings highlight the importance of understanding suicidality through integrated biological, psychological, and social perspectives and reinforce the need for accessible, gender-responsive suicide prevention and mental health services in low-resource urban settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00127-026-03192-3","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T13:40:55Z","timestamp":1787146855000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stress-related salivary biomarkers - cortisol, dehydroepiandrosterone, alpha amylase, and suicidal ideation among young women living in Kampala\u2019s informal settlements"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6963-7892","authenticated-orcid":false,"given":"Godfrey S.","family":"Bbosa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5270-2608","authenticated-orcid":false,"given":"Rachel","family":"Culbreth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7415-094X","authenticated-orcid":false,"given":"Charles","family":"Natuhamya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7463-3490","authenticated-orcid":false,"given":"Jane","family":"Palmier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3846-6014","authenticated-orcid":false,"given":"Gideon","family":"Matovu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6456-0053","authenticated-orcid":false,"given":"Tanja","family":"Jovanovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0365-4379","authenticated-orcid":false,"given":"Rogers","family":"Kasirye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6663-3885","authenticated-orcid":false,"given":"Monica H.","family":"Swahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"3192_CR1","unstructured":"Harmer B, Lee S, Rizvi A, Saadabadi A Suicidal Ideation. 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This study was approved by the Uganda National Council of Science and Technology (UNCST) (HS2959ES) and the Makerere University School of Health Sciences Research and Ethics Committee (MAKSHSREC-2023-532). All participants provided written informed consent before participating in the study. The participants also received remuneration for their time to participate in the study and for providing saliva samples.","order":3,"name":"Ethics","label":"Ethical approval statement for work on human subjects","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"was obtained from all subjects involved in this study.","order":4,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Permission to reproduce material from other sources will be granted upon request to the PI, Dr. Monica H. Swahn.","order":5,"name":"Ethics","label":"Permission to reproduce material from other sources","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"During manuscript revision, the authors used ChatGPT (OpenAI) to assist with language refinement, clarity, organization, and editorial review. The tool was not used to generate data, conduct analyses, or independently interpret the findings. All AI-assisted content was critically reviewed and revised by the authors, who take full responsibility for the accuracy, integrity, and final content of the manuscript.","order":6,"name":"Ethics","label":"Declaration of generative AI use","group":{"name":"EthicsHeading","label":"Declarations"}}]}}