Low total cholesterol and low-density lipoprotein associated with aggression and hostility in recent suicide attempters

Disentangling the relationship between cholesterol, aggression, and impulsivity in severe mental disorders

“…The literature on cholesterol and aggression in psychiatric populations is conflicting. Several studies have shown inverse associations between TC and aggression (Hillbrand et al., 1995; Mufti et al., 1998; Paavola et al., 2002; Roaldset et al., 2011; Suneson et al., 2019) or impulsivity (Kavoor et al., 2017; Troisi, 2011), whereas other studies have reported no significant associations between TC and aggression (Apter et al., 1999; Eriksen et al., 2017; Huang & Wu, 2000; Kavoor et al., 2017; Steinert et al., 1999) or impulsivity (Apter et al., 1999). Importantly, these were observational studies, and the findings may represent reverse causality with cholesterol levels reflecting the severity of distress among specific psychiatric populations.…”

“…Exploratory plots presented in the current study did not indicate nonlinear associations between cholesterol and aggression or impulsivity; thus, no comprehensive investigations targeted at nonlinearity (Sedgwick, Young, Das, & Kumari, 2016) were conducted. (Mufti et al, 1998;Paavola et al, 2002;Suneson et al, 2019).…”

“…Findings among those studies that have investigated high‐density lipoprotein cholesterol (HDL‐C) (Eriksen et al., 2017; Kavoor et al., 2017; Paavola et al., 2002; Suneson et al., 2019; Troisi, 2011) vary from positive (Paavola et al., (2002)), to inverse (Eriksen et al., (2017)), to nonsignificant (Troisi, (2011); Kavoor et al., 2017; Suneson et al., 2019) associations with aggression. Additionally, inverse associations between low‐density lipoprotein cholesterol (LDL‐C) and aggression (Paavola et al., 2002; Suneson et al., 2019) or impulsivity (Kavoor et al., 2017) have been reported. Taken together, the body of evidence appears to be split into suggestions of lipid profile with low cholesterol (TC, LDL‐C) and suggestions of no distinct lipid profile pattern related to aggression.…”

“…Several studies have shown inverse associations between TC and aggression (Hillbrand et al, 1995;Mufti et al, 1998;Paavola et al, 2002;Roaldset et al, 2011;Suneson et al, 2019) or impulsivity (Kavoor et al, 2017;Troisi, 2011), whereas other studies have reported no significant associations between TC and aggression (Apter et al, 1999;Eriksen et al, 2017;Huang & Wu, 2000;Kavoor et al, 2017;Steinert et al, 1999) or impulsivity (Apter et al, 1999). Findings among those studies that have investigated high-density lipoprotein cholesterol (HDL-C) (Eriksen et al, 2017;Kavoor et al, 2017;Paavola et al, 2002;Suneson et al, 2019;Troisi, 2011) vary from positive (Paavola et al, (2002)), to inverse (Eriksen et al, (2017)), to nonsignificant (Troisi, (2011); Kavoor et al, 2017;Suneson et al, 2019) associations with aggression. Additionally, inverse associations between low-density lipoprotein cholesterol (LDL-C) and aggression (Paavola et al, 2002;Suneson et al, 2019) or impulsivity (Kavoor et al, 2017) have been reported.…”

“…Cholesterol and adverse mental symptoms have been investigated over the past three decades in a number of smaller‐to‐medium scaled studies in psychiatric settings (Apter et al., 1999; De Berardis et al., 2013; Eriksen, Bjorkly, Lockertsen, Faerden, & Roaldset, 2017; Huang & Wu, 2000; Kavoor, Mitra, Kumar, Sisodia, & Jain, 2017; Mufti, Balon, & Arfken, 1998; Roaldset, Bakken, & Bjorkly, 2011; Steinert, Woelfle, & Gebhardt, 1999; Suneson et al., 2019; Troisi, 2011; Wu et al., 2016), often showing inverse associations between TC and degree of aggression, impulsivity, or suicidality. Moreover, low TC has been associated with more frequent acts of aggression in forensic psychiatric populations (Hillbrand, Spitz, & Foster, 1995; Paavola, Repo‐Tiihonen, & Tiihonen, 2002).…”