title: CSF monoamine metabolites and lethality of suicide attempts in depressed patients with alcohol dependence.
abstract: BACKGROUND
  Alcohol dependence (alcoholism) and major depressive disorder are frequently comorbid and are risk factors for suicidal behavior. Monoaminergic abnormalities have been implicated in the pathophysiology of depression, alcohol dependence, and suicidal behavior. Lower cerebrospinal fluid (CSF) 5-hydroxyindolacetic acid (5-HIAA) levels are associated with higher lethality of suicide attempts in major depression and predict a higher rate of future suicide. We sought to study the relationship of CSF monoamine metabolites to lethality of suicidal acts in depressed subjects with comorbid alcoholism.
  
  
  METHODS
  We compared 16 high- and 16 low-lethality drug-free depressed suicide attempters with comorbid alcoholism. Subjects were free from any substance use disorder for at least two months. Demographic and clinical parameters, and CSF 5-HIAA, homovanillic acid (HVA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) levels were examined.
  
  
  RESULTS
  The two groups did not differ with regard to the demographic characteristics. CSF 5-HIAA levels were lower in high-lethality attempters compared to low-lethality attempters. There were no group difference in CSF HVA or MHPG levels.
  
  
  CONCLUSIONS
  Higher lethality of suicidal behavior in depressed patients with alcoholism is related to lower serotonergic activity.
authors.affiliation: Division of Neuroscience, Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY 10032, USA. LS2003@columbia.edu
authors.forename: Leo
authors.initials: L
authors.lastname: Sher
authors.forename: Maria A
authors.initials: MA
authors.lastname: Oquendo
authors.forename: Michael F
authors.initials: MF
authors.lastname: Grunebaum
authors.forename: Ainsley K
authors.initials: AK
authors.lastname: Burke
authors.forename: Yung-yu
authors.initials: YY
authors.lastname: Huang
authors.forename: J John
authors.initials: JJ
authors.lastname: Mann
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications*; D015306:Biogenic Monoamines / Q000134:cerebrospinal fluid* / Q000378:metabolism; D003863:Depression / Q000209:etiology* / Q000401:mortality / Q000523:psychology; D005260:Female; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D008875:Middle Aged; D013406:Suicide, Attempted
chemical_list: D015306:Biogenic Monoamines; D008734:Methoxyhydroxyphenylglycol; D006897:Hydroxyindoleacetic Acid; D006719:Homovanillic Acid