Clinical characteristics and biological parameters in temperamental clusters of suicide attempters.
A sample of 215 suicide attempters was categorized in a cluster analysis into four groups according to temperamental trails. Monoamine metabolites in the cerebrospinal fluid were analysed (n = 106). Dexamethasone suppression tests (DST) were performed (n = 154) and the activity of the enzyme monoamine oxidase in platelets (pl-MAO) was assessed (n = 103). Patients belonging to the two clusters with the most deviant temperament profiles (nos 2 and 3) were young and scored high on the Beck Hopelessness Scale and the Suicide Assessment Scale. "Cluster 3" ("neurotic, impulsive, aggressive") patients often had dysthymia and axis II, cluster B diagnoses (e.g. borderline or histrionic personality). "Cluster 2" ("neurotic and introverted") patients often had major depression. The "Cluster 1", with on the whole a normal temperament profile, had significantly higher levels of post-DST cortisol than the other clusters. The "Cluster 4" had a normal temperament profile. Adjustment disorders were most common in "Cluster 1" and "Cluster 4". The monoamine metabolite levels did not differ between the clusters, and the differences in pl-MAO activity disappeared after adjusting for age and gender. The results suggest that temperament profiles in suicide attempters are related to psychiatric diagnoses, suicidality, hopelessness, and post-DST cortisol, but are not predictive of completed suicide.
Engström
G
G
Department of Psychiatry, Lund University Hospital, Sweden.
Alling
C
C
Gustavsson
P
P
Oreland
L
L
Träskman-Bendz
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D008875:Middle Aged; D008995:Monoamine Oxidase / Q000134:cerebrospinal fluid; D013129:Spinal Puncture; D013406:Suicide, Attempted; D013694:Temperament
D008734:Methoxyhydroxyphenylglycol; D003907:Dexamethasone; D008995:Monoamine Oxidase; D006719:Homovanillic Acid