title: Early death and CSF monoamine metabolites in schizophrenia spectrum psychosis.
abstract: 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.
authors.affiliation: Department of Clinical Neuroscience, Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden. andreas.carlborg@sll.se
authors.forename: Andreas
authors.initials: A
authors.lastname: Carlborg
authors.forename: Jussi
authors.initials: J
authors.lastname: Jokinen
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Nordström
authors.forename: Erik G
authors.initials: EG
authors.lastname: Jönsson
authors.forename: Peter
authors.initials: P
authors.lastname: Nordström
mesh_terms: 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
chemical_list: D006897:Hydroxyindoleacetic Acid; D006719:Homovanillic Acid