Plasma total cholesterol in psychiatric patients after a suicide attempt and in follow-up

Low plasma total cholesterol (TC) levels have been found in subjects after a suicide attempt in most studies. Other studies question these results because of possible influences on TC of somatic effects due to the attempt (drugs, somatic trauma, hospitalization), or nutritional habits and physical activity before attempt, especially in patients with depression.

To address this issue, TC levels were estimated in 51 subjects on admission to psychiatric clinic after a suicide attempt, as well as later in follow-up when patients were back in their normal activities. Patients were evaluated for suicide intent (SIS), aggression, and severity of depression (BDI).

A small (7% in the mean) but statistically significant increase in plasma cholesterol levels was observed in samples taken in follow-up compared to samples after attempt. However, TC levels of patients were significantly lower than controls in both assessments. There were no differences in TC between violent and non-violent attempters, either after attempt or in follow-up. In the subgroup of patients with major affective disorder, TC levels were lower compared to age-matched controls in both assessments, although patients showed significant reductions in BDI score in follow-up. In this subgroup, TC levels after attempt correlated negatively to SIS score.

TC levels in psychiatric patients after a suicide attempt are lower than healthy controls and remain low in follow-up, independently from the severity of psychopathology. The results support the role of plasma total cholesterol as a biological risk factor in suicidal behavior, especially in affective patients.