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Aggression, suicidality, and serotonin.

V M Linnoila1, M Virkkunen

  • 1Department of Psychiatry, University of Helsinki, Finland.

The Journal of Clinical Psychiatry
|October 1, 1992
PubMed
Summary
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Low cerebrospinal fluid 5-hydroxyindoleacetic acid (5-HIAA) levels are linked to violent suicide attempts in depressed patients and aggressive behavior in offenders. This may indicate a "low serotonin syndrome" affecting behavior and biological rhythms.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Behavioral Science

Background:

  • Cross-cultural studies indicate a link between violent suicide attempts in unipolar depression and personality disorders.
  • Low concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in cerebrospinal fluid (CSF) have been observed in these patients.

Purpose of the Study:

  • To explore the association between low CSF 5-HIAA levels and violent behavior.
  • To investigate potential pathophysiological mechanisms underlying aggressive and impulsive behaviors.

Main Methods:

  • Review and synthesis of existing international research data.
  • Analysis of correlations between CSF 5-HIAA levels and behavioral patterns.
  • Examination of associated biological and historical factors in affected individuals.

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Main Results:

  • An inverse correlation was found between CSF 5-HIAA concentrations and violent suicide attempts in patients with unipolar depression and personality disorders.
  • A similar correlation was observed between low CSF 5-HIAA and impulsive, externally directed aggression in violent offenders.
  • Low CSF 5-HIAA in offenders was associated with hypoglycemia, early-onset substance abuse, family history of type II alcoholism, and disrupted diurnal rhythms.

Conclusions:

  • Low CSF 5-HIAA may be a biological marker for increased risk of violent behavior and suicide.
  • These findings support a proposed model for the pathophysiology of a 'low serotonin syndrome'.
  • Further research is warranted to understand the implications of this syndrome for treatment and prevention.