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Cigarette smoking, suicidal behavior, and serotonin function in major psychiatric disorders
Kevin M Malone1, Christine Waternaux, Gretchen L Haas
1Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, USA. kmalone@st-vincents.ie
The American Journal of Psychiatry
|April 2, 2003
Summary
Smokers with psychiatric disorders show higher suicide attempt rates and aggression. This association may stem from lower serotonin function, particularly in depressed individuals, suggesting potential therapeutic targets.
Area of Science:
- Neuroscience
- Psychiatry
- Addiction Medicine
Background:
- Cigarette smoking is linked to increased suicide risk, but underlying mechanisms are unclear.
- Lower serotonin function and impulsive/aggressive traits are associated with suicidal behavior.
- This study explores the connection between smoking, suicidal behavior, and serotonin function.
Purpose of the Study:
- To investigate the relationship between cigarette smoking and suicidal behavior.
- To examine the role of serotonin function and impulsive/aggressive traits in this association.
- To explore potential biological explanations for smoking-related suicide risk.
Main Methods:
- 347 psychiatric patients (depression, schizophrenia, other) were assessed for smoking, suicidal behavior, and psychopathology.
- Serotonin function was measured in depressed patients using fenfluramine challenge and CSF 5-HIAA levels.
- Lifetime suicide attempts were present in 53% of subjects.
Main Results:
- Smokers had significantly higher odds of lifetime suicide attempts (OR=2.60) compared to nonsmokers.
- Smokers reported increased suicidal ideation and aggression scores.
- Greater cigarette consumption correlated inversely with serotonin function indices.
Conclusions:
- The link between smoking and suicidal behavior in psychiatric disorders may involve reduced serotonin function in smokers with depression.
- Further research is needed to confirm findings in other disorders and explore serotonin-based treatments.
- Investigating serotonin-enhancing therapies could address both smoking and suicide risk.