Abstract
BackgroundPrevious research on serum total cholesterol and suicidality has yielded conflicting results. Several studies have reported a link between low serum total cholesterol and suicidality, whereas others have failed to replicate these findings, particularly in patients with major affective disorders. These discordant findings may reflect the fact that studies often do not distinguish between patients with bipolar and unipolar depression; moreover, definitions and classification schemes for suicide attempts in the literature vary widely.MethodsSubjects were patients with one of the three major psychiatric disorders commonly associated with suicide: schizophrenia, bipolar affective disorder, and major depressive disorder (MDD). We compared serum lipid levels in patients who died by suicide (82 schizophrenia, 23 bipolar affective disorder, and 67 MDD) and non-suicide controls (200 schizophrenia, 49 bipolar affective disorder, and 175 MDD).ResultsSerum lipid profiles did not differ between patients who died by suicide and control patients in any diagnostic group.ConclusionsOur results do not support the use of biological indicators such as serum total cholesterol to predict suicide risk among patients with a major psychiatric disorder.
Highlights
Previous research on serum total cholesterol and suicidality has yielded conflicting results
Subjects and procedures Using electronic medical records, we identified all patients who were admitted to a psychiatric ward at a university hospital in Seoul, Korea, for schizophrenia (N = 1562), bipolar affective disorder (N = 728), or major depressive disorder (MDD) (N = 1455) between January, 1989, to December, 2006
Schizophrenia patients who died by suicide were composed of 58 paranoid type (70.7%), 3 disorganized type (3.7%), 1 catatonic type (1.2%), and 17 undifferentiated type (20.7%), and 3 residual type (3.7%) and those who did not were composed of 124 paranoid type (75.6%), 3 disorganized type (1.8%), 5 catatonic type (3.0%), and 27undifferentiated type (16.5%) and 5 residual type (3.0%)
Summary
Previous research on serum total cholesterol and suicidality has yielded conflicting results. Several studies have reported a link between low serum total cholesterol and suicidality, whereas others have failed to replicate these findings, in patients with major affective disorders. These discordant findings may reflect the fact that studies often do not distinguish between patients with bipolar and unipolar depression; definitions and classification schemes for suicide attempts in the literature vary widely. Several studies conducted in patients with a major affective disorder have found no significant association between serum cholesterol and suicide [9,10,11,12] These discordant findings may reflect the fact that studies often do not distinguish between patients with bipolar and unipolar depression [5]. Association between cholesterol level and suicidal behavior was mostly investigated in suicide attempters rather than suicide completers [9], suicide completers may be a more homogeneous group than suicide attempters [6]
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