Clinical characteristics and biological parameters in temperamental clusters of suicide attempters

Author(s): Alling, C., Gustavsson, P., Oreland, L., TraskmanBendz, L.

Journal/Book: J Affective Disord. 1997; 44: PO Box 211, 1000 AE Amsterdam, Netherlands. Elsevier Science BV. 45-55.

Abstract: A sample of 215 suicide attempters was categorized in a cluster analysis into four groups according to temperamental traits. Monoamine metabolites in the cerebrospinal fluid were analysed (n = 106). Dexamethasone suppression tests (DST) were performed (n = 154) and the activity of the enzyme monoamine oxidase in platelets (pl-MAO) was assessed (n = 103). Patients belonging to the two clusters with the most deviant temperament profiles (nos 2 and 3) were young and scored high on the Beck Hopelessness Scale and the Suicide Assessment Scale. ''Cluster 3'' (''neurotic, impulsive, aggressive'') patients often had dysthymia and axis II, cluster B diagnoses (e.g. Borderline or histrionic personality). ''Cluster 2'' (''neurotic and introverted'') patients often had major depression. The ''Cluster 1'', with on the whole a normal temperament profile, had significantly higher levels of post-DST cortisol than the other clusters. The ''Cluster 4'' had a normal temperament profile. Adjustment disorders were most common in ''Cluster 1'' and ''Cluster 4''. The monoamine metabolite levels did not differ between the clusters, and the differences in pl-MAO activity disappeared after adjusting for age and gender, The results suggest that temperament profiles in suicide attempters are related to psychiatric diagnoses, suicidality, hopelessness, and post-DST cortisol, but are not predictive of completed suicide.

Note: Article Engstrom G, Univ Lund Hosp, Dept Psychiat, Lund Suicide Res Ctr, S-22185 Lund, SWEDEN

Keyword(s): temperament; suicide attempts; depression; monoamine metabolites; monoamine oxidase; dexamethasone; PLATELET MAO ACTIVITY; DEXAMETHASONE SUPPRESSION TEST; CSF-AMINE METABOLITES; CEREBROSPINAL-FLUID; MONOAMINE METABOLITES; PSYCHIATRIC-PATIENTS; PERSONALITY-TRAITS; HEALTHY-VOLUNTEERS; VIOLENT OFFENDERS; FIRE SETTERS

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