Reduced cerebrospinal HVA concentrations and HVA/5-HIAA ratios in suicide attempters
Abstract
Dysfunctions of central monoaminergic systems are important elements of the leading biological hypotheses of suicide and depression. The purpose of the present paper was to study the levels and the relationships between the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA), the dopamine metabolite homovanillic acid (HVA) and the norepinephrine metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) in the cerebrospinal fluid (CSF) in 120 hospitalised suicide attempters and 47 controls (healthy volunteers or patients admitted for minor surgery). The suicide attempters showed significantly lower HVA levels (174+/-82 vs. 216+/-96 nmol/L, P=0.004), HVA/5HIAA ratios (1.6+/-0.5 vs. 2.1+/-0.6, P=0.0001) and HVA/MHPG ratios (4.2+/-2.1 vs. 4.8+/-1.7, P=0.02) than the controls. The correlations between the monoamine metabolites were markedly lower in patients than in controls. CSF 5-HIAA showed no significant differences between patients and controls (107+/-40 vs. 108+/-51 nmol/L) or between violent and non-violent attempters (112+/-58 vs. 105+/-33 nmol/L). The monoamine metabolites showed no significant differences between survivors and patients who subsequently completed suicide, or between suicide attempters subgrouped by psychiatric diagnoses. The results suggest that low HVA levels and altered relationships between the monoamine metabolites are associated with suicidal behaviour.
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Lower CSF homovanillic acid (HVA) levels in suicide attempters point to low dopaminergic function, possibly underlying anhedonia and motivational deficits.
“Lower CSF homovanillic acid (HVA) levels in suicide attempters point to low dopaminergic function, possibly underlying anhedonia and motivational deficits (29, 30).”
From Exploring the neurobiological markers of suicidal behaviors in pediatric population: a narrative review (2026) · cites this paper as [30]
Abnormalities in dopaminergic, glutamatergic, GABAergic, and endocannabinoid systems have been implicated in suicide.
“Abnormalities in dopaminergic, glutamatergic, GABAergic, and endocannabinoid systems have also been implicated in suicide.”
From Exploring the neurobiological markers of suicidal behaviors in pediatric population: a narrative review (2026) · cites this paper as [30]
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“Lower CSF homovanillic acid (HVA) levels in suicide attempters point to low dopaminergic function, possibly underlying anhedonia and motivational deficits (29, 30).”
- Authors
- Engström, G., Alling, C., Blennow, K., Regnéll, G., & Träskman-Bendz, L.
- Affiliations
- Skåne University Hospital (SE)
- University of Gothenburg (SE)
- Corresponding author
- Engström, Gunnar
- Venue
- European Neuropsychopharmacology
- Publisher
- Elsevier BV
- Published
- 1999-09
- Volume
- 9
- Issue
- 5
- Pages
- 399-405
- ISSN
- 0924-977X (ISSN-L)
- OpenAlex
- W17887401
- Cited by
- 157
- References
- 42
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 3 · 2021: 6 · 2020: 2 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 5 · 2015: 8 · 2014: 3 · 2013: 9 · 2012: 6
- FWCI
- 7.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- suicide attempters, homovanillic acid, 5-hydroxyindoleacetic acid, MHPG, monoamine metabolites, cerebrospinal fluid, suicidal behavior
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Mental Disorders, Female, Homovanillic Acid, Humans, Hydroxyindoleacetic Acid, Male, Methoxyhydroxyphenylglycol, Middle Aged, Psychiatric Status Rating Scales, Suicide, Attempted, Biomarkers
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