Attempted Suicide Characteristics and Cerebrospinal Fluid Amine Metabolites in Depressed Inpatients
Abstract
Background Serotonin abnormalities have been reported in the brain of suicide victims. Evidence of a serotonin deficiency in suicide attempters is less consistent. We hypothesized that a serotonin deficiency may be present in suicide attempters whose attempt behavior more closely approximates completed suicide.Method Sixty-seven (67) drug-free depressed inpatients (46 suicide attempters, 21 nonattempters) underwent research clinical assessments and a lumbar puncture. Cerebrospinal fluid (CSF) monoamine metabolites were assayed. Degree of medical damage and intent of the most recent suicide attempt were rated.Results CSF amine metabolites did not differentiate suicide attempters as a group from nonattempters. However, reduced serotonergic activity, as indicated by lower levels of CSF-5-hydroxyindoleacetic acid (5-HIAA) was associated with a history of planned suicide attempts and with suicide attempts that resulted in greater medical damage. Other monoamine metabolites did not correlate with seriousness of suicidal behavior, except for low CSF homovanillic acid and higher medical damage. No correlation was found with violent method.Conclusions Planned and more medically damaging suicide attempts appear to be associated specifically with low serotonergic activity and, therefore, resemble completed suicide both behaviorally and biochemically. It remains to be determined whether low levels of CSF 5-HIAA can predict greater medical damage in future suicide attempts.
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Clinical Correlates of Planned and Unplanned Suicide Attempts
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Self-citationEvolution of serotonin: sunlight to suicide
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Biological markers for suicidal behavior in alcohol dependence
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Future prospects in depression research
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Self-citationLower CSF MHPG predicts short-term risk for suicide attempt
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BIOLOGIC ALTERATIONS IN THE BRAINSTEM OF SUICIDES
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Clinical and Genetic Risk Factors for Suicide under the Influence of Alcohol in a Polish Sample
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Platelet 5-HT2A receptor subresponsivity and lethality of attempted suicide in depressed in-patients
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Self-citationEvolution of Serotonin: Sunlight to Suicide
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Abnormal stress responsiveness and suicidal behavior: a risk phenotype
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Relationship of stress-reactive cortisol to suicidal intent of prior attempts in major depression
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- Authors
- Mann, J.
- Affiliations
- Columbia University (US)
- Corresponding author
- Mann, J
- Venue
- Neuropsychopharmacology
- Published
- 1996-12
- Volume
- 15
- Issue
- 6
- Pages
- 576-586
- ISSN
- 0893-133X (ISSN-L)
- OpenAlex
- W1990830006
- Cited by
- 178
- References
- 74
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 7 · 2020: 5 · 2018: 3 · 2017: 3 · 2016: 7 · 2015: 6 · 2014: 9 · 2013: 9 · 2012: 7
- FWCI
- 8.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1r01mh040048-01)
- National Institute of Mental Health (MH-40048, MH48514, MH46745, R01MH048514)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- suicide attempts, depression, cerebrospinal fluid, serotonin, 5-hydroxyindoleacetic acid, monoamine metabolites, homovanillic acid, suicidal intent, suicide mortality, suicide risk prediction
- MeSH terms
- Adult, Aged, Chromatography, High Pressure Liquid, Depressive Disorder, Female, Homovanillic Acid, Humans, Hydroxyindoleacetic Acid, Inpatients, Male, Methoxyhydroxyphenylglycol, Middle Aged, Severity of Illness Index, Suicide, Attempted
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