Suicidal Behavior in Schizophrenia may be Related to Low Lipid Levels

Abstract

BackgroundLifetime suicide mortality in people with schizophrenia is approximately 4–5%, which is higher than in the general population. In mood disorders, many studies and meta-analyses have shown a link between suicidal behavior and low lipid levels, especially that of cholesterol, and some studies have also suggested such a relationship in schizophrenia. Therefore, the aim of the present study was to investigate a possible correlation between suicidal behavior and lipid levels in schizophrenia patients recently admitted to a psychiatric hospital.Material/MethodsOur study included 148 (69 males, 79 females) schizophrenia patients with a mean age of 32±10 years, all recently admitted due to acute exacerbation of their mental illness. Psychometric and laboratory assessments were made within 24–72 hours after hospital admission. The main purpose of the interview was to assess occurrence of any suicidal thoughts, suicidal tendencies, and/or suicide attempts during the 3 months prior to admission. Serum total, LDL and HDL cholesterol, as well as triglycerides and total lipids were measured.ResultsA significant association was found between suicidal thoughts and attempts and low total cholesterol, LDL cholesterol, triglycerides, and total lipids, in both male and female patients. In male patients with suicidal tendencies, correlation with low LDL cholesterol and triglycerides did not reach statistical significance. No association with suicidality was found with HDL cholesterol in subjects studied.ConclusionsThe results obtained suggest that, similar to depressed patients, low total and LDL cholesterol, triglycerides, and total lipids can be state-dependent risk factors for suicidal behavior in Polish patients with schizophrenia.

Worldwide prevalence of suicidal ideation and suicide plan among people with schizophrenia: a meta-analysis and systematic review of epidemiological surveys

“… No. First author (publication year) References Country Survey time Study design Sampling method Sample size Demographic information Schizophrenia-related information SI-related information Quality assessment score Source of patients Mean age (years) Male gender proportion (%) Average education level (years) Diagnostic criteria a Average onset age (years) Average duration of illness (years) Measure instrument Timeframe of SI 1 Acosta (2020) [ 73 ] Spain 2012−2015 Cohort Non-probability sampling 133 Outpatient 46.7 69.2 Categorical data ICD-10 NR 20.84 Scale Lifetime 4 2 Ainiyet (2014) [ 37 ] Poland Sept. 2005−Jun. 2006 Cross-sectional Non-probability sampling 148 Inpatient 32 46.63 NR DSM-IV NR 7 Interview 3-month 4 3 Dell’Osso (2012) b [ 25 ] Italy NR Cross-sectional Non-probability sampling 79 Mixed 36.28 69.6 Categorical data DSM-IV NR NR Question Lifetime 5 4 Duko (2018) [ 74 ] …”

“…2a ), and the pooled point prevalence of SI was 29.9% (95% CI: 24.2−35.6%; I 2 = 89.5%). The 3-month prevalence [ 37 ], 1-year prevalence [ 20 ], and prevalence of SI during more than 1 month period before admission [ 38 ] was 44.6%, 16.2%, and 19.6%, respectively. The lifetime prevalence of SP was 44.3% [ 25 ], and point prevalence of SP in two studies was 6.4% [ 26 ] and 13% [ 24 ], respectively.…”

The association between altered lipid profile and suicide attempt among Tunisian patients with schizophrenia

“…However, Janusz et al [23] have reported that total cholesterol, LDL cholesterol, total lipids, and triglycerides are significantly lower in patients with schizophrenia who had a suicidal attempt. In terms of gender differences, we must emphasize that females may be especially sensitive to dieting-induced changes in the central serotonin function [39].…”

“…Many researchers have focused on the search of biological markers that may be linked to suicidal behavior and can be used as an additional instrument for prevention and therapeutic action. It has been found that metabolic deregulation, especially altered lipid profile including low total cholesterol (TC) and low-density lipoproteins-cholesterol (LDL-c) levels, may underlie higher suicide risk in patients with schizophrenia [1, 3]. A number of studies have investigated a possible link between low serum cholesterol and psychiatric symptoms, especially suicidal behavior [36].…”

Copeptin levels and blood lipid profile in borderline patients with or without self-mutilation

“…There is even information that aggressive behaviour increased with the reduction in cholesterol levels in the field of anti-hyperlipidemic therapy. 18 Studies have demonstrated that low serum cholesterol was related to suicidal behaviour in antisocial personality disorder 19 and schizophrenia 20 patients. It was found that the decrease in cholesterol levels reduced serotonin receptor sensitivity by altering the fluidity of neuron membranes.…”