CSF5-HIAA levels are lower in impulsive as compared to nonimpulsive violent suicide attempters and control subjects

Background: We studied CSF 5-HIAA and HVA concentrations in violent suicide attempters and examined their relationship with depression, anxiety, and i mpulsivity. Methods: CSF 5-HIAA and HVA concentrations were determined very shortly aft er hospital admission and compared to those of a matched control population , Clinical evaluation was performed concomitantly; the level impulsivity wa s evaluated by the Impulsivity Rating Scale (IRS), Results: Twenty-three patients and 23 control subjects were included, Accor ding to the IRS, 14 patients were classified as impulsive, including all pa tients suffering from personality disorders, and 9 as nonimpulsive, with a main DSM-IIIR diagnosis of melancholia. CSF 5-HIAA concentrations in the su icide group were significantly lower than in control subjects. This differe nce was,as entirely due to the impulsive suicide attempters. There was an i nverse correlation between the IRS score and CSF 5-HIAA (r = -.47, p =.02) and only a trend for KVA (r = -.41, p = .078) levels in the suicide group. Conclusions: This study of a group of violent suicide attempters distinguis hed a subgroup of patients diagnosed with personality disorder with high im pulsivity scores and a subgroup of patients with the main diagnosis of seve re depression. CSF 5-HIAA was significantly lower in impulsive violent atte mpters than in nonimpulsive violent attempters, therefore desintangling vio lence from impulsivity and linking this biologic abnormality to impulsivity .