CSF 5-HIAA levels are lower in impulsive as compared to nonimpulsive violent suicide attempters and control subjects.
BACKGROUND
We studied CSF 5-HIAA and HVA concentrations in violent suicide attempters and examined their relationship with depression, anxiety, and impulsivity.


METHODS
CSF 5-HIAA and HVA concentrations were determined very shortly after hospital admission and compared to those of a matched control population. Clinical evaluation was performed concomitantly; the level impulsivity was evaluated by the Impulsivity Rating Scale (IRS).


RESULTS
Twenty-three patients and 23 control subjects were included. According to the IRS, 14 patients were classified as impulsive, including all patients suffering from personality disorders, and 9 as nonimpulsive, with a main DSM-IIIR diagnosis of melancholia. CSF 5-HIAA concentrations in the suicide group were significantly lower than in control subjects. This difference was entirely due to the impulsive suicide attempters. There was an inverse correlation between the IRS score and CSF 5-HIAA (r = -.47, p = .02) and only a trend for HVA (r = -.41, p = .078) levels in the suicide group.


CONCLUSIONS
This study of a group of violent suicide attempters distinguished a subgroup of patients diagnosed with personality disorder with high impulsivity scores and a subgroup of patients with the main diagnosis of severe depression. CSF 5-HIAA was significantly lower in impulsive violent attempters than in nonimpulsive violent attempters, therefore desintangling violence from impulsivity and linking this biologic abnormality to impulsivity.
Cremniter
D
D
Département de Psychopathologie, Centre Hospitalier Henri Mondor, Creteil, France.
Jamain
S
S
Kollenbach
K
K
Alvarez
J C
JC
Lecrubier
Y
Y
Gilton
A
A
Jullien
P
P
Lesieur
P
P
Bonnet
F
F
Spreux-Varoquaux
O
O
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid*; D007175:Impulsive Behavior / Q000097:blood* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D013129:Spinal Puncture; D013406:Suicide, Attempted / Q000523:psychology*; D014754:Violence
D006897:Hydroxyindoleacetic Acid; D006719:Homovanillic Acid