Low serum cholesterol in violent but not in non-violent suicide attempters

Many previous studies have suggested that low or lowered serum cholesterol levels may increase the risk of mortality not due to somatic disease: princ ipally, suicide and violent death. Because violent death is rare, some stud ies have investigated afterwards the relation between cholesterol levels an d either suicide attempts in psychiatric populations or violence in crimina lly violent populations. However, none of these studies have compared chole sterol levels in violent and non-violent suicide attempters. The blood of 2 5 consecutive drug-free patients following a violent suicide attempt and of 27 patients following a non-violent suicide attempt by drug overdose was d rawn in the 24 h following admission. Patients with a diagnosis of alcohol abuse and with cholesterol-lowering therapy were excluded. Age, sex, body m ass index, psychiatric diagnosis and the physical conditions of the suicide attempt were investigated. Thirty-two healthy subjects were used as a cont rol group. There were no differences between the groups in age, frequency o f psychiatric diagnoses or body mass index. There was more women in the gro up of non-violent suicide attempters than in that of violent suicide attemp ters (P < 0.001). In analyses controlling for sex and age, the serum choles terol concentration was 30% lower (F-2,F-82 = 15.8; P < 0.0001) in the grou p of violent suicide attempters (147 +/- 54 mg/dl) than in the group of non -violent suicide attempters (209 +/- 38 mg/dl) or control subjects (213 +/- 46 mg/dl). Our results showed that low serum cholesterol level is associat ed with the violence of the suicide attempt and net with the suicide attemp t itself. Further investigations are necessary to determine the usefulness of this easily accessible parameter as a potential risk indicator for viole nt acts such as violent suicidal behavior in susceptible individuals. (C) 2 000 Elsevier Science Ireland Ltd. All rights reserved.