Suicide attempts and impulse control disorder are related to low cerebrospinal fluid 5-HIAA in mentally disordered violent offenders

Author(s): Belfrage, H., Bertilsson, L., Evenden, M. M., Asberg, M.

Journal/Book: Acta Psychiat Scand. 2000; 101: 35 Norre Sogade, PO Box 2148, Dk-1016 Copenhagen, Denmark. Munksgaard Int Publ Ltd. 395-402.

Abstract: Objective: The aim of this study was to investigate the relationship between low cerebrospinal fluid 5-hydroxyindoleacetic acid (CSF 5 HIAA) and aggressive acts in mentally disordered violent offenders. Method: CSF concentrations of 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid and 4-hydroxy-3-methoxyphenyl glycol were measured in 35 drug-free men convicted of homicide and currently undergoing forensic psychiatric investigation in a high security hospital. Results: The mean metabolite concentrations in the homicide offenders did not differ from those of age- and body-height matched male control subjects. One-third of the murderers had made one or several suicide attempts, and their mean concentration of spinal fluid 5-HIAA was significantly lower than that of the remaining murderers. Subjects with impulse control disorder also had lower mean CSF 5-HIAA. A consistent pattern of higher CSF 5-HIAA in subjects with more self-reported anxiety traits was observed. Conclusion: The association between serotonin and suicidal behaviour holds for yet another subject group. Determining CSF 5-HIAA might be worth while in the routine assessment of psychiatrically ill homicide offenders.

Note: Article Lidberg L, Huddinge Hosp, Div Forens Psychiat, Div Clin Neurosci & Family Med, Karolinska Inst, POB 4044, S-14104 Huddinge, SWEDEN

Keyword(s): serotonin; homicide; suicide; forensic psychiatry; MONOAMINE METABOLITES; AMINE METABOLITES; RECEPTOR-BINDING; FIRE SETTERS; CSF 5-HIAA; BEHAVIOR; PERSONALITY; SEROTONIN; ALCOHOLICS; DEPRESSION

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