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Journal of Psychiatry & Neuroscience : JPN logoLink to Journal of Psychiatry & Neuroscience : JPN
. 2000 Sep;25(4):371–377.

Relation of serum cholesterol, lipid, serotonin and tryptophan levels to severity of depression and to suicide attempts.

L G Almeida-Montes 1, V Valles-Sanchez 1, J Moreno-Aguilar 1, R A Chavez-Balderas 1, J A García-Marín 1, J F Cortés Sotres 1, G Hheinze-Martin 1
PMCID: PMC1407732  PMID: 11022402

Abstract

OBJECTIVE: To determine if there is a relation to low serum cholesterol, lipoprotein, serotonin or tryptophan levels in patients with depression who have recently attempted suicide. DESIGN: Biochemical and behavioural study. SETTING: Inpatient and outpatient treatment at the Instituto Mexicano de Psiquiatría. PARTICIPANTS: Thirty-three patients with a diagnosis of major depressive episode. Eighteen of these patients had attempted suicide in the month before the start of the study; 15 patients had never attempted suicide. OUTCOME MEASURES: Serum levels of total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, serotonin (5-HT) and tryptophan. Scores on Hamilton Depression Rating Scale, Carroll Depression Rating Scale, Beck Hopelessness Scale and Beck Suicide Attempt Severity Scale. RESULTS: There were no significant differences between patients who had attempted suicide and those who had not in terms of serum cholesterol, HDL, LDL and triglyceride levels. Serum levels of 5-HT and tryptophan were significantly lower in patients with depression who had a recent suicide attempt than in those patients who had never attempted suicide. A comparison of patients not taking antidepressant medication found serum 5-HT levels to be more than 3 times lower in those patients with a recent suicide attempt than in patients with no history of suicide attempt. CONCLUSIONS: The study found no difference in lipid profiles between patients who had attempted suicide and those who had not. Low serum levels of 5-HT may increase the risk of suicide attempt in patients who are depressed.

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Selected References

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  1. Allain C. C., Poon L. S., Chan C. S., Richmond W., Fu P. C. Enzymatic determination of total serum cholesterol. Clin Chem. 1974 Apr;20(4):470–475. [PubMed] [Google Scholar]
  2. Anderson G. M., Feibel F. C., Cohen D. J. Determination of serotonin in whole blood, platelet-rich plasma, platelet-poor plasma and plasma ultrafiltrate. Life Sci. 1987 Mar 16;40(11):1063–1070. doi: 10.1016/0024-3205(87)90568-6. [DOI] [PubMed] [Google Scholar]
  3. Asberg M., Träskman L., Thorén P. 5-HIAA in the cerebrospinal fluid. A biochemical suicide predictor? Arch Gen Psychiatry. 1976 Oct;33(10):1193–1197. doi: 10.1001/archpsyc.1976.01770100055005. [DOI] [PubMed] [Google Scholar]
  4. Assmann G., Jabs H. U., Kohnert U., Nolte W., Schriewer H. LDL-cholesterol determination in blood serum following precipitation of LDL with polyvinylsulfate. Clin Chim Acta. 1984 Jun 27;140(1):77–83. doi: 10.1016/0009-8981(84)90153-0. [DOI] [PubMed] [Google Scholar]
  5. Beck A. T., Weissman A., Lester D., Trexler L. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol. 1974 Dec;42(6):861–865. doi: 10.1037/h0037562. [DOI] [PubMed] [Google Scholar]
  6. Boston P. F., Dursun S. M., Reveley M. A. Cholesterol and mental disorder. Br J Psychiatry. 1996 Dec;169(6):682–689. doi: 10.1192/bjp.169.6.682. [DOI] [PubMed] [Google Scholar]
  7. Bucolo G., David H. Quantitative determination of serum triglycerides by the use of enzymes. Clin Chem. 1973 May;19(5):476–482. [PubMed] [Google Scholar]
  8. Carroll B. J., Feinberg M., Smouse P. E., Rawson S. G., Greden J. F. The Carroll rating scale for depression. I. Development, reliability and validation. Br J Psychiatry. 1981 Mar;138:194–200. doi: 10.1192/bjp.138.3.194. [DOI] [PubMed] [Google Scholar]
  9. Chen Z., Peto R., Collins R., MacMahon S., Lu J., Li W. Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations. BMJ. 1991 Aug 3;303(6797):276–282. doi: 10.1136/bmj.303.6797.276. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Chin J. R. Determination of the catecholamines and serotonin, their precursors tyrosine and tryptophan, and their main metabolites in rat brain using reversed-phase high-performance liquid chromatography with fluorimetric and oxidative amperometric detection in series. J Chromatogr. 1992 Jul 1;578(1):17–30. doi: 10.1016/0378-4347(92)80220-k. [DOI] [PubMed] [Google Scholar]
  11. Cleare A. J., Bond A. J. Effects of alterations in plasma tryptophan levels on aggressive feelings. Arch Gen Psychiatry. 1994 Dec;51(12):1004–1005. doi: 10.1001/archpsyc.1994.03950120076017. [DOI] [PubMed] [Google Scholar]
  12. Dealberto M. J., Ducimetiere P., Mainard F., Alperovitch A. Serum lipids and depression. Lancet. 1993 Feb 13;341(8842):435–435. [PubMed] [Google Scholar]
  13. Gallerani M., Manfredini R., Caracciolo S., Scapoli C., Molinari S., Fersini C. Serum cholesterol concentrations in parasuicide. BMJ. 1995 Jun 24;310(6995):1632–1636. doi: 10.1136/bmj.310.6995.1632. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Golier J. A., Marzuk P. M., Leon A. C., Weiner C., Tardiff K. Low serum cholesterol level and attempted suicide. Am J Psychiatry. 1995 Mar;152(3):419–423. doi: 10.1176/ajp.152.3.419. [DOI] [PubMed] [Google Scholar]
  15. Grove T. H. Effect of reagent pH on determination of high-density lipoprotein cholesterol by precipitation with sodium phosphotungstate-magnesium. Clin Chem. 1979 Apr;25(4):560–564. [PubMed] [Google Scholar]
  16. HAMILTON M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960 Feb;23:56–62. doi: 10.1136/jnnp.23.1.56. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Hawthon K., Cowen P., Owens D., Bond A., Elliott M. Low serum cholesterol and suicide. Br J Psychiatry. 1993 Jun;162:818–825. doi: 10.1192/bjp.162.6.818. [DOI] [PubMed] [Google Scholar]
  18. Heron D. S., Shinitzky M., Hershkowitz M., Samuel D. Lipid fluidity markedly modulates the binding of serotonin to mouse brain membranes. Proc Natl Acad Sci U S A. 1980 Dec;77(12):7463–7467. doi: 10.1073/pnas.77.12.7463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Kavoussi R., Armstead P., Coccaro E. The neurobiology of impulsive aggression. Psychiatr Clin North Am. 1997 Jun;20(2):395–403. doi: 10.1016/s0193-953x(05)70319-1. [DOI] [PubMed] [Google Scholar]
  20. Kromhout D., Katan M. B., Menotti A., Keys A., Bloemberg B. Serum cholesterol and long-term death rates from suicide, accidents, or violence. Seven Countries Study Group. Lancet. 1992 Aug 1;340(8814):317–317. doi: 10.1016/0140-6736(92)92415-c. [DOI] [PubMed] [Google Scholar]
  21. Law M. R., Thompson S. G., Wald N. J. Assessing possible hazards of reducing serum cholesterol. BMJ. 1994 Feb 5;308(6925):373–379. doi: 10.1136/bmj.308.6925.373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Lowering cholesterol concentrations and mortality. BMJ. 1990 Sep 15;301(6751):552–555. doi: 10.1136/bmj.301.6751.552-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Lucca A., Lucini V., Piatti E., Ronchi P., Smeraldi E. Plasma tryptophan levels and plasma tryptophan/neutral amino acids ratio in patients with mood disorder, patients with obsessive-compulsive disorder, and normal subjects. Psychiatry Res. 1992 Nov;44(2):85–91. doi: 10.1016/0165-1781(92)90043-3. [DOI] [PubMed] [Google Scholar]
  24. Maes M., Scharpé S., Verkerk R., D'Hondt P., Peeters D., Cosyns P., Thompson P., De Meyer F., Wauters A., Neels H. Seasonal variation in plasma L-tryptophan availability in healthy volunteers. Relationships to violent suicide occurrence. Arch Gen Psychiatry. 1995 Nov;52(11):937–946. doi: 10.1001/archpsyc.1995.03950230051008. [DOI] [PubMed] [Google Scholar]
  25. Maes M., Schotte C., D'Hondt P., Claes M., Vandewoude M., Scharpe S., Cosyns P. Biological heterogeneity of melancholia: results of pattern recognition methods. J Psychiatr Res. 1991;25(3):95–108. doi: 10.1016/0022-3956(91)90003-s. [DOI] [PubMed] [Google Scholar]
  26. Mauri M. C., Ferrara A., Boscati L., Bravin S., Zamberlan F., Alecci M., Invernizzi G. Plasma and platelet amino acid concentrations in patients affected by major depression and under fluvoxamine treatment. Neuropsychobiology. 1998;37(3):124–129. doi: 10.1159/000026491. [DOI] [PubMed] [Google Scholar]
  27. Modai I., Valevski A., Dror S., Weizman A. Serum cholesterol levels and suicidal tendencies in psychiatric inpatients. J Clin Psychiatry. 1994 Jun;55(6):252–254. [PubMed] [Google Scholar]
  28. Morgan R. E., Palinkas L. A., Barrett-Connor E. L., Wingard D. L. Plasma cholesterol and depressive symptoms in older men. Lancet. 1993 Jan 9;341(8837):75–79. doi: 10.1016/0140-6736(93)92556-9. [DOI] [PubMed] [Google Scholar]
  29. Muldoon M. F., Manuck S. B., Matthews K. A. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. BMJ. 1990 Aug 11;301(6747):309–314. doi: 10.1136/bmj.301.6747.309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Neaton J. D., Blackburn H., Jacobs D., Kuller L., Lee D. J., Sherwin R., Shih J., Stamler J., Wentworth D. Serum cholesterol level and mortality findings for men screened in the Multiple Risk Factor Intervention Trial. Multiple Risk Factor Intervention Trial Research Group. Arch Intern Med. 1992 Jul;152(7):1490–1500. [PubMed] [Google Scholar]
  31. Oxenkrug G. F., Branconnier R. J., Harto-Truax N., Cole J. O. Is serum cholesterol a biological marker for major depressive disorder? Am J Psychiatry. 1983 Jul;140(7):920–921. doi: 10.1176/ajp.140.7.920. [DOI] [PubMed] [Google Scholar]
  32. Papassotiropoulos A., Hawellek B., Frahnert C., Rao G. S., Rao M. L. The risk of acute suicidality in psychiatric inpatients increases with low plasma cholesterol. Pharmacopsychiatry. 1999 Jan;32(1):1–4. doi: 10.1055/s-2007-979181. [DOI] [PubMed] [Google Scholar]
  33. Ploeckinger B., Dantendorfer K., Ulm M., Baischer W., Derfler K., Musalek M., Dadak C. Rapid decrease of serum cholesterol concentration and postpartum depression. BMJ. 1996 Sep 14;313(7058):664–664. doi: 10.1136/bmj.313.7058.664. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Quintana J. Platelet serotonin and plasma tryptophan decreases in endogenous depression. Clinical, therapeutic, and biological correlations. J Affect Disord. 1992 Feb;24(2):55–62. doi: 10.1016/0165-0327(92)90019-3. [DOI] [PubMed] [Google Scholar]
  35. Randall T., Muir J., Mant D. Choosing the preventive workload in general practice: practical application of the Coronary Prevention Group guidelines and Dundee coronary risk-disk. BMJ. 1992 Jul 25;305(6847):227–231. doi: 10.1136/bmj.305.6847.227. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Raucoules D., Azorin J. M., Barre A., Tissot R. Taux plasmatiques et transports membranaires dans le globule rouge de la tyrosine et du tryptophane dans les états dépressifs. Evaluation en ligne de base et á l'euthymie. Encephale. 1991 May-Jun;17(3):197–201. [PubMed] [Google Scholar]
  37. Ryan M., Murray F. E. Serum cholesterol concentrations in parasuicide. Scottish study does not replicate findings. BMJ. 1995 Sep 23;311(7008):807–807. doi: 10.1136/bmj.311.7008.807b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Sarrias M. J., Cabré P., Martínez E., Artigas F. Relationship between serotoninergic measures in blood and cerebrospinal fluid simultaneously obtained in humans. J Neurochem. 1990 Mar;54(3):783–786. doi: 10.1111/j.1471-4159.1990.tb02319.x. [DOI] [PubMed] [Google Scholar]
  39. Strandberg T. E., Salomaa V. V., Naukkarinen V. A., Vanhanen H. T., Sarna S. J., Miettinen T. A. Long-term mortality after 5-year multifactorial primary prevention of cardiovascular diseases in middle-aged men. JAMA. 1991 Sep 4;266(9):1225–1229. [PubMed] [Google Scholar]
  40. Strandberg T. E., Valvanne J., Tilvis R. S. Serum lipids and depression. Lancet. 1993 Feb 13;341(8842):433–434. doi: 10.1016/0140-6736(93)93026-w. [DOI] [PubMed] [Google Scholar]
  41. Sullivan P. F., Joyce P. R., Bulik C. M., Mulder R. T., Oakley-Browne M. Total cholesterol and suicidality in depression. Biol Psychiatry. 1994 Oct 1;36(7):472–477. doi: 10.1016/0006-3223(94)90643-2. [DOI] [PubMed] [Google Scholar]
  42. Takei N., Kunugi H., Nanko S., Aoki H., Iyo R., Kazamatsuri H. Low serum cholesterol and suicide attempts. Br J Psychiatry. 1994 May;164(5):702–703. doi: 10.1192/s0007125000034632. [DOI] [PubMed] [Google Scholar]
  43. Tiihonen J., Räsänen P., Hakko H. Seasonal variation in the occurrence of homicide in Finland. Am J Psychiatry. 1997 Dec;154(12):1711–1714. doi: 10.1176/ajp.154.12.1711. [DOI] [PubMed] [Google Scholar]
  44. Yates W. R., Wallace R. Cardiovascular risk factors in affective disorder. J Affect Disord. 1987 Mar-Apr;12(2):129–134. doi: 10.1016/0165-0327(87)90004-8. [DOI] [PubMed] [Google Scholar]
  45. Zureik M., Courbon D., Ducimetière P. Serum cholesterol concentration and death from suicide in men: Paris prospective study I. BMJ. 1996 Sep 14;313(7058):649–651. doi: 10.1136/bmj.313.7058.649. [DOI] [PMC free article] [PubMed] [Google Scholar]

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