title: CSF 5-HIAA and exposure to and expression of interpersonal violence in suicide attempters.
abstract: BACKGROUND
  Serotonin is implicated in impaired impulse control, aggression and suicidal behaviour. Low cerebrospinal fluid (CSF) concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) have been found in violent suicide attempters, suicide victims and in violent offenders. CSF 5-HIAA concentrations have both genetic and environmental determinants. Childhood trauma may have an effect on central monoamine function as an adult.
  
  
  OBJECTIVE
  The aim of this study was to assess the relationship of CSF 5-HIAA and the exposure to and the expression of violence in childhood and during adult life measured with the Karolinska Interpersonal Violence Scale (KIVS).
  
  
  METHODS
  42 medication free suicide attempters underwent lumbar puncture and were assessed with the Karolinska Interpersonal Violence Scale (KIVS) to assess history of childhood exposure to violence and lifetime expressed violent behaviour.
  
  
  RESULTS
  In women, but not in men, CSF 5-HIAA showed a significant negative correlation to exposure to violence during childhood. Furthermore, suicide attempters with low CSF 5-HIAA were more prone to commit violent acts as an adult if exposed to violence as a child compared to suicide attempters with high CSF 5-HIAA. In the non-traumatized group, CSF 5-HIAA showed a significant negative correlation to expressed violent behaviour in childhood.
  
  
  CONCLUSIONS
  Although central serotonergic function has important genetic determinants, exposure to childhood trauma may also affect serotonergic function. Low serotonergic function may facilitate impaired aggression control in traumatized suicide attempters.
authors.affiliation: The Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Moberg
authors.forename: P
authors.initials: P
authors.lastname: Nordström
authors.forename: K
authors.initials: K
authors.lastname: Forslund
authors.forename: M
authors.initials: M
authors.lastname: Kristiansson
authors.forename: M
authors.initials: M
authors.lastname: Asberg
authors.forename: J
authors.initials: J
authors.lastname: Jokinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000374:Aggression / Q000502:physiology; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid*; D008297:Male; D001523:Mental Disorders / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013223:Statistics as Topic; D013406:Suicide, Attempted / Q000523:psychology*; D014754:Violence / Q000523:psychology*; D055815:Young Adult
chemical_list: D006897:Hydroxyindoleacetic Acid