Early death and CSF monoamine metabolites in schizophrenia spectrum psychosis.
BACKGROUND
Patients with schizophrenia have higher rates of mortality than the general population. Lower concentrations of the cerebrospinal fluid (CSF) monoamine metabolites homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) have been associated with suicidal, aggressive and impulsive behavior. Mortality has been suggested as a measure of impulsivity and a relationship between early death and lower concentrations of CSF monoamine metabolites has been reported but the studies are few with short periods of follow-up and small numbers.


OBJECTIVE
The objective of this study was to investigate a relationship between early death and concentrations of CSF 5-HIAA and HVA.


METHODS
Three hundred and eighty-five inpatients with schizophrenia spectrum psychosis were lumbar punctured in a standardized manner and followed for a median of 26 years. Patients were searched to identify those who had died. Causes of death were obtained from the Causes of Death Register.


RESULTS
During the time of follow-up, 97 patients died. Schizophrenia spectrum psychosis patients died at an earlier age from both natural and unnatural causes of death. No significant associations were found between CSF 5-HIAA and HVA concentrations and non-suicidal death. Attempted suicide was not a risk factor for non-suicidal death at younger age.


CONCLUSIONS
Patients with schizophrenia spectrum psychosis die at an earlier age from both natural and unnatural causes of death. Attempted suicide is not a risk factor for non-suicidal death at younger age. Low concentrations of CSF HVA and 5-HIAA were not a risk factor for non-suicidal death at younger age in schizophrenia spectrum psychosis.
Carlborg
Andreas
A
Department of Clinical Neuroscience, Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden. andreas.carlborg@sll.se
Jokinen
Jussi
J
Nordström
Anna-Lena
AL
Jönsson
Erik G
EG
Nordström
Peter
P
D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D002555:Cerebrospinal Fluid / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid*; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012559:Schizophrenia / Q000378:metabolism* / Q000401:mortality*; D012565:Schizophrenic Psychology; D013548:Sweden; D055815:Young Adult
D006897:Hydroxyindoleacetic Acid; D006719:Homovanillic Acid