title: Association of aggressive behavior with altered serotonergic function in patients who are not suicidal.
abstract: OBJECTIVE
  The purpose of this study was to determine whether aggression and serotonergic dysfunction are related in the absence of a history of suicidal behavior. Although serotonergic dysfunction has been implicated in aggressive and impulsive behavior, most studies of such behavior have included individuals with a history of suicide attempts. Low concentrations of CSF 5-hydroxyindoleacetic acid (5-HIAA) have been consistently associated with suicidal behavior, presenting a potential confound in the link between aggression and serotonergic dysfunction.
  
  
  METHODS
  The authors examined the association between aggression and CSF 5-HIAA concentrations in a group of 64 patients who had different DSM-III-R axis I diagnoses and no past suicidal behavior. Aggressive (N=35) and nonaggressive (N=29) groups were defined by a median split on a six-item history of adulthood aggressive behavior.
  
  
  RESULTS
  The aggressive group had significantly lower CSF 5-HIAA concentrations than the nonaggressive group. Aggressive individuals also scored significantly higher on self-report measures of hostility, impulsiveness, and sensation seeking. CSF 5-HIAA concentrations, however, did not correlate with self-reported hostility and impulsivity.
  
  
  CONCLUSIONS
  There is an association between aggressive behavior and serotonergic dysfunction independent of suicidal behavior in patients with axis I disorders who exhibit relatively milder forms of aggressive behavior. Analogous to findings with suicidal behavior, a low concentration of CSF 5-HIAA is related to aggressive behavior but does not show the same relationship to the continuum of aggressive feelings and thoughts.
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA.
authors.forename: B
authors.initials: B
authors.lastname: Stanley
authors.forename: A
authors.initials: A
authors.lastname: Molcho
authors.forename: M
authors.initials: M
authors.lastname: Stanley
authors.forename: R
authors.initials: R
authors.lastname: Winchel
authors.forename: M J
authors.initials: MJ
authors.lastname: Gameroff
authors.forename: B
authors.initials: B
authors.lastname: Parsons
authors.forename: J J
authors.initials: JJ
authors.lastname: Mann
mesh_terms: D000328:Adult; D000374:Aggression / Q000502:physiology* / Q000523:psychology; D010054:Brief Psychiatric Rating Scale; D005260:Female; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D007175:Impulsive Behavior / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D001523:Mental Disorders / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000503:physiopathology*; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012701:Serotonin / Q000502:physiology*; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D012701:Serotonin; D006897:Hydroxyindoleacetic Acid