Attempted suicide characteristics and cerebrospinal fluid amine metabolites in depressed inpatients
Attempted suicide characteristics and cerebrospinal fluid amine metabolites in depressed inpatients
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DOI：
10.1016/s0893-133x(96)00102-9
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发表时间：
1996-12-01
影响因子：
7.6
通讯作者：
Stanley, M
中科院分区：
文献类型：
--
作者：
Mann, JJ;Malone, KM;Stanley, M
背景：据报道，自杀受害者的大脑中存在5-羟色胺异常。自杀未遂者缺乏5-羟色胺的证据不太一致。我们推测，自杀未遂者可能存在5-羟色胺缺乏，他们的自杀未遂行为更接近于完全自杀。方法：对67例住院的无毒抑郁症患者(自杀未遂者46例，非自杀未遂者21例)进行研究、临床评估和腰椎穿刺术。测定脑脊液(CSF)单胺代谢产物。对最近一次自杀未遂的医疗损害程度和意图进行了评级。结果：脑脊液胺类代谢产物不能区分自杀未遂者和非自杀未遂者。然而，5-羟色胺能活性降低，如较低的脑脊液5-羟基吲哚乙酸[5-HIAA]水平所表明的，与有计划的自杀未遂和导致更大医疗损害的自杀未遂有关。除低脑脊液高香草酸和较高的医疗损害外，其他单胺代谢物与自杀行为的严重性无关。用暴力法未发现相关性。结论：有计划的、更具医学破坏性的自杀企图似乎特别与低5-羟色胺能活动有关，因此，在行为和生化上都类似于完全自杀。低水平的脑脊液5-HIAA是否能预测未来自杀企图中更大的医疗损害仍有待确定。(C)1996年美国神经精神药理学学院
Background: Serotonin abnormalities have been reported in the brain of suicide victims. Evidence of a serotonin deficiency in suicide attempters is less consistent. We hypothesized that a serotonin deficiency may be present in suicide attempters whose attempt behavior more closely approximates completed suicide. Method: Sixty-seven (67) drug-free depressed inpatients (46 suicide attempters, 21 nonattempters) underwent research clinical assessments and a lumbar puncture. Cerebrospinal fluid (CSF) monoamine metabolites were assayed. Degree of medical damage and intent of the most recent suicide attempt were rated. Results: CSF amine metabolites did not differentiate suicide attempters as a group from nonattempters. However, reduced serotonergic activity, as indicated by lower levels of CSF 5-hydroxyindoleacetic acid [5-HIAA] was associated with a history of planned suicide attempts and with suicide attempts that resulted in greater medical damage. Other monoamine metabolites did not correlate with seriousness of suicidal behavior, except for low CSF homovanillic acid and higher medical damage. No correlation was found with violent method. Conclusions: Planned and more medically damaging suicide attempts appear to be associated specifically with low serotonergic activity and, therefore, resemble completed suicide both behaviorally and biochemically. It remains to be determined whether low levels of CSF 5-HIAA can predict greater medical damage in future suicide attempts. (C) 1996 American College of Neuropsychopharmacology