Attempted Suicide characteristics and cerebrospinal fluid amine metabolites in depressed inpatients

J. John Mann, Kevin M. Malone, John A. Sweeney, Richard P. Brown, Markku Linnoila, Barbara Stanley, Michael Stanley

Research output: Contribution to journalArticlepeer-review

142 Scopus citations


Background: Serotonin abnormalities have been reported in the brain of suicide victims. Evidence of serotonin deficiency in suicide attempters is less consistent. We hypothesized that a serotonin deficiency may be present in suicide attempters whose attempt behavior more closely approximates completed suicide. Method: Sixty-seven (67) drug-free depressed inpatients (46 suicide attempters, 21 nonattempters) underwent research clinical assessments and a lumbar puncture. Cerebrospinal fluid (CSF) monoamine metabolites were assayed. Degree of medical damage and intent of the most recent suicide attempt were rated. Results: CSF amine metabolites did not differentiate suicide attempters as a group from nonattempters. However, reduced serotonergic activity, as indicated by lower levels of CSF 5-hydroxyindoleacetic acid (5-HIAA) was associated with a history of planned suicide attempts and with suicide attempts that resulted in greater medical damage. Other monoamine metabolites did not correlate with seriousness of suicidal behavior, except for low CSF homovanillic acid and higher medical damage. No correlation was found with violent method. Conclusions: Planned and more medically damaging suicidide attempts appear to be associated specifically with low serotonergic activity and, therefore, resemble completed suicide both behaviorally and biochemically. It remains to be determined whether low levels of CSF 5-HIAA can predict greater medical damage in future-suicide attempts.

Original languageEnglish (US)
Pages (from-to)576-586
Number of pages11
Issue number6
StatePublished - Dec 1996


  • CSF amine metabolites
  • Depression
  • Serotonin
  • Suicide

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health


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