ATTEMPTED-SUICIDE CHARACTERISTICS AND CEREBROSPINAL-FLUID AMINE METABOLITES IN DEPRESSED INPATIENTS

Background: Serotonin abnormalities have been reported in the brain of suicide victims. Evidence of a serotonin deficiency in suicide attemp ters is less consistent. We hypothesized that a serotonin deficiency m ay be present in suicide attempters whose attempt behavior more closel y approximates completed suicide. Method: Sixty-seven (67) drug-free d epressed inpatients (46 suicide attempters, 21 nonattempters) underwen t research clinical assessments and a lumbar puncture. Cerebrospinal f luid (CSF) monoamine metabolites were assayed. Degree of medical damag e and intent of the most recent suicide attempt were rated. Results: C SF amine metabolites did not differentiate suicide attempters as a gro up from nonattempters. However, reduced serotonergic activity, as indi cated by lower levels of CSF 5-hydroxyindoleacetic acid [5-HIAA] was a ssociated with a history of planned suicide attempts and with suicide attempts that resulted in greater medical damage. Other monoamine meta bolites did not correlate with seriousness of suicidal behavior, excep t for low CSF homovanillic acid and higher medical damage. No correlat ion was found with violent method. Conclusions: Planned and more medic ally damaging suicide attempts appear to be associated specifically wi th low serotonergic activity and, therefore, resemble completed suicid e both behaviorally and biochemically. It remains to be determined whe ther low levels of CSF 5-HIAA can predict greater medical damage in fu ture suicide attempts. (C) 1996 American College of Neuropsychopharmac ology