0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letter to the Editor   |    
High Serum Cholesterol and Suicide Risk
TAKESHI TERAO, M.D., PH.D.; RICHARD WHALE, M.D.
Am J Psychiatry 2001;158:824-824. doi:10.1176/appi.ajp.158.5.824

To the Editor: We read with much interest the article by Antti Tanskanen, M.D., Ph.D., et al. (1), which demonstrated the positive relationship of high serum total cholesterol levels to greater risk of violent suicide. This report went on to suggest an association between high total cholesterol level and depression (by means of a correlation of both high total cholesterol level and depression with low omega-3 polyunsaturated fatty acids). We argue that the link with high total cholesterol level and depression is unlikely to be exclusive. First, Dr. Tanskanen et al. (1) found no association between high total cholesterol level and risk of nonviolent suicide. Because suicides associated with depression include both violent and nonviolent ones, the hypothesis of a direct association between high total cholesterol level and depression is unlikely.

Second, Partonen et al. (2)demonstrated that a low total cholesterol level was associated with depressed mood and subsequently a high risk of hospital treatment because of major depressive disorder and death from suicide in a large sample of men. Also, Terao et al. (3) found the greatest number of depressive states in the subject group with the lowest cholesterol levels (<158 mg/dl), although peaks in numbers of depressive states were seen throughout the range of stratified cholesterol levels.

Neuroendocrine studies (4, 5) complicate the picture, as both subjects with total cholesterol levels less than 150 mg/dl (4) and with low levels of high-density lipoprotein cholesterol (5) had significantly blunted cortisol responses to an m-CPP challenge (which could be associated with reduced serotonergic function and depressive states). Buydens-Branchey et al. (5) found an association between low high-density lipoprotein level and a history of aggression, which is possibly consistent with the argument of Dr. Tanskanen et al.

We conclude that a high level of total cholesterol is not exclusively linked to depressive disorders, but the overall picture is complicated. As Dr. Tanskanen et al. (1) found, depressed subjects with high cholesterol levels may be at a greater vulnerability to violent suicide, but the reasons for this are unclear.

Tanskanen A, Vartiainen E, Tuomilehto J, Viinamäki H, Lehtonen J, Puska P: High serum cholesterol and risk of suicide. Am J Psychiatry  2000; 157:648–650
[PubMed]
[CrossRef]
 
Partonen T, Haukka J, Virtamo J, Taylor PR, Lonnqvist J: Association of low serum total cholesterol with major depression and suicide. Br J Psychiatry  1999; 175:259–262
[PubMed]
[CrossRef]
 
Terao T, Iwata N, Kanazawa K, Takano T, Takahashi N, Hayashi T, Sugawara Y: Low serum cholesterol levels and depressive state in human dock visitors. Acta Psychiatr Scand  2000; 101:231–234
[PubMed]
[CrossRef]
 
Terao T, Yoshimura R, Ohmori O, Takano T, Takahashi N, Iwata N, Suzuki T, Abe K: Effect of serum cholesterol levels on meta-chlorophenylpiperazine-evoked neuroendocrine responses in healthy subjects. Biol Psychiatry  1997; 41:974–978
[PubMed]
[CrossRef]
 
Buydens-Branchey L, Branchey M, Hudson J, Fergeson P: Low HDL cholesterol, aggression, and altered central serotonergic activity. Psychiatry Res  2000; 93:93–102
[PubMed]
[CrossRef]
 
+

References

Tanskanen A, Vartiainen E, Tuomilehto J, Viinamäki H, Lehtonen J, Puska P: High serum cholesterol and risk of suicide. Am J Psychiatry  2000; 157:648–650
[PubMed]
[CrossRef]
 
Partonen T, Haukka J, Virtamo J, Taylor PR, Lonnqvist J: Association of low serum total cholesterol with major depression and suicide. Br J Psychiatry  1999; 175:259–262
[PubMed]
[CrossRef]
 
Terao T, Iwata N, Kanazawa K, Takano T, Takahashi N, Hayashi T, Sugawara Y: Low serum cholesterol levels and depressive state in human dock visitors. Acta Psychiatr Scand  2000; 101:231–234
[PubMed]
[CrossRef]
 
Terao T, Yoshimura R, Ohmori O, Takano T, Takahashi N, Iwata N, Suzuki T, Abe K: Effect of serum cholesterol levels on meta-chlorophenylpiperazine-evoked neuroendocrine responses in healthy subjects. Biol Psychiatry  1997; 41:974–978
[PubMed]
[CrossRef]
 
Buydens-Branchey L, Branchey M, Hudson J, Fergeson P: Low HDL cholesterol, aggression, and altered central serotonergic activity. Psychiatry Res  2000; 93:93–102
[PubMed]
[CrossRef]
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Books
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 3.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 43.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 43.  >
APA Practice Guidelines > Chapter 11.  >
APA Practice Guidelines > Chapter 11.  >
Topic Collections
Psychiatric News
APA Guidelines