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A prospective study of lipids and serotonin as risk markers of violence and self-harm in acute psychiatric patients

Psychiatry Research. 186 (2011) s. 293–299 | 2011


Cross-sectional studies have reported an association between lipids and serotonin levels and aggression, but
a literature search revealed a paucity of prospective studies. Subjects of the present naturalistic study were
254 of all (489) involuntary and voluntary acutely admitted patients to a psychiatric hospital during 1 year.
Serum lipids and platelet serotonin at admission were prospectively compared with recorded intrainstitutional
and 1-year post-discharge violence and self-harm. Total cholesterol had a significant negative
relationship to inpatient suicidal behaviour and inpatient violent behaviour and to 3-month post-discharge
violent behaviour. Triglycerides were a significant marker of inpatient self-mutilation and of self-mutilation
in combination with suicidal behaviour at 3 and 12 months of follow-up. High-density lipoprotein (HDL) had
a significant negative relationship to violence at 12-months, and to repeated violence in seven patients with
two or more admissions. The post-discharge relationships between total cholesterol and violence and
between triglycerides and self-harm remained significant even when controlling for other possible
explanatory variables in a multivariate model. Results did not change after controlling for current
medication at admission. There was no association between platelet serotonin and violence or self-harm.
Future research may examine if lipid measurements add incremental validity to established clinical risk
assessment procedures of violent and self-harm behaviour.