title: Association between total serum cholesterol and depression, aggression, and suicidal ideations in war veterans with posttraumatic stress disorder: a cross-sectional study.
abstract: OBJECTIVE
  To investigate the relationship between total serum cholesterol and levels of depression, aggression, and suicidal ideations in war veterans with posttraumatic stress disorder (PTSD) without psychiatric comorbidity.
  
  
  METHODS
  A total of 203 male PTSD outpatients were assessed for the presence of depression, aggression, and suicidality using the 17-item Hamilton Depression Rating Scale (HAM-D17), Corrigan Agitated Behavior Scale (CABS), and Scale for Suicide Ideation (SSI), respectively, followed by plasma lipid parameters determination (total cholesterol, high density lipoprotein [HDL]-cholesterol, low density lipoprotein [LDL]-cholesterol, and triglycerides). PTSD severity was assessed using the Clinician-Administered PTSD Scale for DSM-IV, Current and Lifetime Diagnostic Version (CAPS-DX) and the Clinical Global Impressions of Severity Scale (CGI-S), before which Mini-International Neuropsychiatric Interview (MINI) was administered to exclude psychiatric comorbidity and premorbidity.
  
  
  RESULTS
  After adjustments for PTSD severity, age, body mass index, marital status, educational level, employment status, use of particular antidepressants, and other lipid parameters (LDL- and HDL- cholesterol and triglycerides), higher total cholesterol was significantly associated with lower odds for having higher suicidal ideation (SSI≥20) (odds ratio [OR] 0.09; 95% confidence interval [CI] 0.03-0.23], clinically significant aggression (CABS≥22) (OR 0.28; 95% CI 0.14-0.59), and at least moderate depressive symptoms (HAM-D17≥17) (OR 0.20; 95% CI 0.08-0.48). Association of total cholesterol and HAM-D17 scores was significantly moderated by the severity of PTSD symptoms (P<0.001).
  
  
  CONCLUSIONS
  Our results indicate that higher total serum cholesterol is associated with lower scores on HAM-D17, CABS, and SSI in patients with chronic PTSD.
authors.affiliation: Maja Vilibic, Vrapce University Psychiatric Hospital, Department of Biological Psychiatry and Psychogeriatrics, Bolnicka 32, 10 090 Zagreb, Croatia, maja.vilibic@gmail.com.
authors.forename: Maja
authors.initials: M
authors.lastname: Vilibić
authors.forename: Vlado
authors.initials: V
authors.lastname: Jukić
authors.forename: Mirna
authors.initials: M
authors.lastname: Pandžić-Sakoman
authors.forename: Petar
authors.initials: P
authors.lastname: Bilić
authors.forename: Milan
authors.initials: M
authors.lastname: Milošević
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology*; D002784:Cholesterol / Q000097:blood*; D017523:Croatia; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000097:blood*; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000523:psychology*; D059020:Suicidal Ideation; D014728:Veterans; D014857:Warfare
chemical_list: D002784:Cholesterol