CSF 5-HIAA predicts suicide risk after attempted suicide

Area of Science:

• Neuroscience
• Psychiatry
• Biochemistry

Background:

• Suicide remains a significant public health concern, particularly among individuals with mood disorders.
• Predicting suicide risk accurately is crucial for effective intervention and prevention strategies.
• Cerebrospinal fluid (CSF) monoamine metabolite concentrations have been investigated as potential biomarkers for suicide risk.

Purpose of the Study:

• To investigate the predictive value of cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) concentrations for short-term suicide risk.
• To examine the relationship between low CSF 5-HIAA levels and suicide occurrence within one year following a suicide attempt in mood disorder patients.

Main Methods:

• A cohort of 92 psychiatric inpatients with mood disorders, admitted after a suicide attempt, were analyzed.
• CSF samples were collected, and 5-hydroxyindoleacetic acid (5-HIAA) concentrations were measured.
• Survival analysis was employed to assess the association between CSF 5-HIAA levels (stratified by median split) and suicide within the first year post-attempt.

Main Results:

• Eleven patients (12%) died by suicide within one year of their index suicide attempt.
• A significantly higher suicide rate (17%) was observed in patients with below-median CSF 5-HIAA levels (< 87 nM) compared to those with above-median levels (7%).
• The cumulative survival time during the first year was significantly lower in the low CSF 5-HIAA subgroup.

Conclusions:

• Low CSF 5-HIAA concentrations are a significant predictor of short-range suicide risk in psychiatric patients with mood disorders who have previously attempted suicide.
• These findings provide further evidence supporting the serotonin hypothesis of suicide.
• CSF 5-HIAA may serve as a valuable biomarker for identifying high-risk individuals requiring closer monitoring and intervention.