MONOAMINE METABOLITES IN CEREBROSPINAL FLUID IN RELATION TO DEPRESSIVE ILLNESS, SUICIDAL BEHAVIOUR AND PERSONALITY

Abstract

ABSTRACT In the present review of studies of cerebrospinal fluid concentrations of metabolites of serotonin, dopamine and noradrenaline in depressed patients and healthy volunteer controls, the importance of taking variables such as the subects' age and body height into account is discussed. Concentrations of 5-HIAA and HVA decrease with increasing body height. All three metabolites tend to increase with age. Endogenously depressed patients have significantly lower CSF concentrations of 5-HIAA and HVA than controls only after matching for sex, age and body height. There is a trend to a seasonal variability in CSF 5-HIAA, with lower concentrations in late autumn in depressives and in controls. Repeated examinations show a significant increase in CSF 5-HIAA in recovered depressives. A low CSF 5-HIAA was associated with an increased frequency of suicidal acts. In patients who had made a suicide attempt and had a CSF 5-HIAA concentration below 90 nanomol/L the one year mortality in suicide was 22 per cent. Patients with low CSF 5-HIAA had significantly higher ratings of aggression and anxiety (based on Rorschach protocols) than patients with normal 5-HIAA, but equal ratings of depression.