Cholesterol levels discounted as a biological marker for
suicide risk among alcoholics
Alcoholism is a major risk factor for suicidal behavior.
Prior research has suggested that cholesterol may be a
general biological marker for suicide risk.
New
research discounts cholesterol levels as a biological
marker for suicide attempt risk among alcoholics, but
identifies a "profile" of patients at risk.
Alcoholism is a major risk factor for suicidal behavior.
Previous research has suggested that cholesterol may
serve as a biological marker for suicide risk among
various psychiatric patient groups. In the March issue
of Alcoholism: Clinical & Experimental Research,
researchers examine both demographic factors and
selected serum lipid concentrations in alcoholic
patients. Results do not support an association between
cholesterol and suicide attempts; however, they do
indicate that alcoholic patients who attempt suicide
have a particular profile.
"Up
to seven percent of alcoholic patients die from suicide,
and about one third of these patients attempt suicide at
least once in life," said Eberhard A. Deisenhammer,
associate professor of psychiatry at the Innsbruck
Medical University and corresponding author for the
study. "However, since many alcoholics are reluctant to
seek treatment for their problem, a significant portion
of potentially suicidal alcoholic patients go
undetected. We wanted to investigate if elevated serum
cholesterol levels could serve to identify these
individuals early enough to help them."
"Recent studies have found that individuals with lower
cholesterol levels may be more likely to either attempt
or complete suicide, but the evidence is far from
established," added Guilherme Luiz Guimaraes Borges, a
professor of epidemiology at the Universidad Autónoma
Metropolitana-Xochimilco in Mexico City. "Given that
several disorders, as part of their prevention or
treatment strategies, call for a reduction in levels of
cholesterol in the blood, this study could have
repercussions for treatment of several disorders, not
just alcoholics and suicidal patients."
Deisenhammer and his colleagues in Austria interviewed
and took blood samples from 110 alcoholic patients who
were admitted to a psychiatric university hospital
department for in-patient treatment. Study participants
were grouped according to whether or not they had
attempted suicide during their lifetimes: attempters
versus non-attempters, and attempters who used a violent
versus a non-violent suicide method were compared.
Researchers analyzed the participants' blood samples for
total cholesterol, high-density lipoprotein (HDL)
cholesterol, low-density lipoprotein (LDL) cholesterol,
and triglycerides.
Study results do not support an association between
cholesterol and suicide attempts.
However, patients who had attempted suicide at least
once in their life had a significantly different profile
than those with no history of suicide attempts: they
were younger, more often smokers, had more frequently
co-abused benzodiazepines (central nervous system
depressants used mostly to relieve anxiety and
insomnia), and scored higher on the global Montgomery
and Åsberg Depression Rating Scale (MADRS) as well as on
the MADRS "suicidal thoughts" item. The latter finding
would suggest a chronically higher vulnerability for
depression and suicidality. Moreover, there were
indications that higher serum triglyceride levels may be
a risk factor for suicide attempts in the patient
population.
"Our
results add to several other study findings questioning
the importance of low serum total cholesterol as a trait
marker for suicidal patients in general," said
Deisenhammer. "Maybe future studies will show that there
are subgroups of patients for which cholesterol may be
useful as a biological suicide marker. Until that time,
doctors and relatives of alcoholics should consider the
possibility that their patient/husband/colleague may be,
or become, suicidal. Until we have easily applicable
biological risk markers at our disposal, they will need
to assess suicide risk primarily through conversation."
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Alcoholism: Clinical & Experimental Research
(ACER) is the official journal of the Research Society
on Alcoholism and the International Society for
Biomedical Research on Alcoholism. Co-authors of the
ACER paper, "Serum Lipids and Risk Factors for Attempted
Suicide in Patients with Alcohol Dependence," were:
Theresia Lechner-Schoner, Georg Kemmler, Alexander Ober,
Eva Braidt, and Hartmann Hinterhuber of the Department
of General Psychiatry at Innsbruck Medical University.