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      Cerebrospinal fluid monoamine metabolites and suicide.

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          Abstract

          Prospective studies of the serotonergic system and suicide report that low 5-hydroxyindolacetic acid (5-HIAA) in the cerebrospinal fluid (CSF) and a history of attempted suicide predict suicide risk. Low CSF homovanillic acid (HVA) is reported to be associated with past and future lethality of suicide attempts but not with suicide. The interrelationships between monoamine metabolites, violent method, suicide intent and lethality of suicidal behaviour are complex. We hypothesized that CSF 5-HIAA and HVA levels are related to suicide intent, violence and lethality of suicidal behaviour. Fifteen male suicide attempters admitted to a psychiatric ward at the Karolinska University Hospital and eight healthy male volunteers were submitted to lumbar puncture and CSF 5-HIAA and HVA were assayed. Suicide intent with the Beck Suicide Intent Scale (SIS), lethality and violence of suicidal behaviour were assessed. All patients were followed up for causes of death. Six suicides and one fatal accident were identified with death certificates. Mean CSF 5-HIAA but not CSF HVA differed between suicides and survivors. Violent suicides had higher suicide intent and CSF 5-HIAA than non-violent suicides. In violent suicides, CSF 5-HIAA levels were negatively correlated with SIS. Greater suicide intent may be associated with greater aggressive intent and predicts a violent suicide method.

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          Author and article information

          Journal
          Nord J Psychiatry
          Nordic journal of psychiatry
          Informa UK Limited
          1502-4725
          0803-9488
          2009
          : 63
          : 4
          Affiliations
          [1 ] Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. jussi.jokinen@ki.se
          Article
          905987278
          10.1080/08039480802571077
          19034712
          c0ba8b88-ad2e-4005-8aaa-178e977827cf
          History

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