Abstract
Starting in the 1960s, investigators began to note several biologic characteristics associated with suicidal behavior: high excretion of 17-hydroxycorticosteroids in urine, low monoamine oxidase (MAO) activity in blood platelets, blunted thyroid stimulating hormone response to thyroid releasing hormone and, finally, low levels of dopamine metabolite, homovanillic acid (HVA), and of serotonin metabolite, 5-hydroxyindoleacetic acid (5-HIAA) in the cerebrospinal fluid (CSF). Because low 5-HIAA levels were reported also in depressives and because patients are often both suicidal and depressed, more recent research has focused on the link between low 5-HIAA levels, depression, and suicidal behavior. At this year's Seventh World Congress of Psychiatry in Vienna, the nature of this link further unfolded. Eugene S. Paykel, MD, FRCP, FRCPsych, reported that major depression seems to precede a moderately high proportion of [actual] suicides but much lower proportion of attempted suicides. The latter behavior probably characterizes distinct group, added
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