CSF 5‐HIAA Predicts Suicide Risk After Attempted Suicide

Abstract

Suicide risk after attempted suicide, as predicted by cerebrospinal fluid (CSF) monoamine metabolite concentrations, was studied in a sample of 92 psychiatric mood disorder inpatients admitted shortly after attempting suicide. The potential of the serotonin metabolite 5‐hydroxyindoleacetic acid (5‐HIAA) in the CSF to predict suicide risk within the first year after attempted suicide was studied by means of survival analysis after median split sub‐grouping. Eleven patients (12%) committed suicide within 1 year after attempted suicide. Eight of these belonged to the below‐the‐median (< 87 nM) CSF 5‐HIAA subgroup, that is, the suicide risk was 17% as compared with 7% among those with above‐the‐median CSF 5‐HIAA. The cumulative number of survived patient‐months during the first year after attempted suicide was significantly lower in the low CSF 5‐HIAA subgroup. It was concluded that low CSF 5‐HIAA predicts short‐range suicide risk after attempted suicide in mood disorder psychiatric inpatients. These findings lend further support to the serotonin hypothesis of suicide risk.