Suicide attempts and impulse control disorder are related to low cerebrospinal fluid 5-HIAA in mentally disordered violent offenders.
OBJECTIVE
The aim of this study was to investigate the relationship between low cerebrospinal fluid 5-hydroxyindoleacetic acid (CSF 5-HIAA) and aggressive acts in mentally disordered violent offenders.


METHODS
CSF concentrations of 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid and 4-hydroxy-3-methoxyphenyl glycol were measured in 35 drug-free men convicted of homicide and currently undergoing forensic psychiatric investigation in a high security hospital.


RESULTS
The mean metabolite concentrations in the homicide offenders did not differ from those of age- and body-height matched male control subjects. One-third of the murderers had made one or several suicide attempts, and their mean concentration of spinal fluid 5-HIAA was significantly lower than that of the remaining murderers. Subjects with impulse control disorder also had lower mean CSF 5-HIAA. A consistent pattern of higher CSF 5-HIAA in subjects with more self-reported anxiety traits was observed.


CONCLUSIONS
The association between serotonin and suicidal behaviour holds for yet another subject group. Determining CSF 5-HIAA might be worth while in the routine assessment of psychiatrically ill homicide offenders.
Lidberg
L
L
Department of Clinical Neuroscience and Family Medicine, Karolinska Institutet, Huddinge Hospital, Sweden.
Belfrage
H
H
Bertilsson
L
L
Evenden
M M
MM
Asberg
M
M
D000328:Adult; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000134:cerebrospinal fluid* / Q000150:complications* / Q000175:diagnosis; D006708:Homicide; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid*; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D014754:Violence
D008734:Methoxyhydroxyphenylglycol; D006897:Hydroxyindoleacetic Acid; D006719:Homovanillic Acid