Cholesterol levels discounted as a biological marker for suicide risk among alcoholics
- Alcoholism is a major risk factor for suicidal behavior.
- Prior research has suggested that cholesterol may be a general biological marker for suicide risk.
- New research discounts cholesterol levels as a biological marker for suicide attempt risk among alcoholics, but identifies a "profile" of patients at risk.
"Up to seven percent of alcoholic patients die from suicide, and about one third of these patients attempt suicide at least once in life," said Eberhard A. Deisenhammer, associate professor of psychiatry at the Innsbruck Medical University and corresponding author for the study. "However, since many alcoholics are reluctant to seek treatment for their problem, a significant portion of potentially suicidal alcoholic patients go undetected. We wanted to investigate if elevated serum cholesterol levels could serve to identify these individuals early enough to help them."
"Recent studies have found that individuals with lower cholesterol levels may be more likely to either attempt or complete suicide, but the evidence is far from established," added Guilherme Luiz Guimaraes Borges, a professor of epidemiology at the Universidad Autˇnoma Metropolitana-Xochimilco in Mexico City. "Given that several disorders, as part of their prevention or treatment strategies, call for a reduction in levels of cholesterol in the blood, this study could have repercussions for treatment of several disorders, not just alcoholics and suicidal patients."
Deisenhammer and his colleagues in Austria interviewed and took blood samples from 110 alcoholic patients who were admitted to a psychiatric university hospital department for in-patient treatment. Study participants were grouped according to whether or not they had attempted suicide during their lifetimes: attempters versus non-attempters, and attempters who used a violent versus a non-violent suicide method were compared. Researchers analyzed the participants' blood samples for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides.
Study results do not support an association between cholesterol and suicide attempts.
However, patients who had attempted suicide at least once in their life had a significantly different profile than those with no history of suicide attempts: they were younger, more often smokers, had more frequently co-abused benzodiazepines (central nervous system depressants used mostly to relieve anxiety and insomnia), and scored higher on the global Montgomery and ┼sberg Depression Rating Scale (MADRS) as well as on the MADRS "suicidal thoughts" item. The latter finding would suggest a chronically higher vulnerability for depression and suicidality. Moreover, there were indications that higher serum triglyceride levels may be a risk factor for suicide attempts in the patient population.
"Our results add to several other study findings questioning the importance of low serum total cholesterol as a trait marker for suicidal patients in general," said Deisenhammer. "Maybe future studies will show that there are subgroups of patients for which cholesterol may be useful as a biological suicide marker. Until that time, doctors and relatives of alcoholics should consider the possibility that their patient/husband/colleague may be, or become, suicidal. Until we have easily applicable biological risk markers at our disposal, they will need to assess suicide risk primarily through conversation."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Serum Lipids and Risk Factors for Attempted Suicide in Patients with Alcohol Dependence," were: Theresia Lechner-Schoner, Georg Kemmler, Alexander Ober, Eva Braidt, and Hartmann Hinterhuber of the Department of General Psychiatry at Innsbruck Medical University.
Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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