Roggenbach Jens, Müller-Oerlinghausen Bruno, Franke Leonora
Former Research Group Clinical Psychopharmacology, Freie Universität Berlin, 14050, Berlin, Germany.
Psychiatry Res. 2002 Dec 15;113(1-2):193-206. doi: 10.1016/s0165-1781(02)00230-5.
In biological suicide research, low cerebrospinal fluid-5-hydroxyindolacetic acid (CSF-5HIAA) concentrations have been associated with suicidality, aggression and impulsivity. However, it frequently appears that the interpretation of existing study results is flawed. The analysis of various published findings suggests that contaminating factors like impulsivity or depressive symptoms in suicide attempters are often not taken into consideration at the time of suicide. The seemingly 'robust' association of low CSF-5HIAA concentration with 'suicidality' and 'aggression' is in fact rather weak. Reported associations of subgroups of suicidal behavior (e.g. violent suicide attempts) with low CSF-5HIAA concentrations are likely to represent somewhat premature translations of findings from studies that have flaws in methodology. Furthermore, the perception of 'suicidal behavior' as autoaggressive behavior or inwardly directed aggression in the view of the authors may not be useful in biological suicide research. The construct of aggressivity is insufficiently defined, resulting in difficulties to interpret empirical data. Some evidence exists, however, that reduced CSF-5HIAA concentrations might be related to certain depressive symptoms and changes in impulsivity. More carefully designed studies are required to overcome the existing methodological shortcomings.
在生物自杀研究中，脑脊液5-羟吲哚乙酸（CSF-5HIAA）浓度低与自杀倾向、攻击性和冲动性有关。然而，现有研究结果的解释常常存在缺陷。对各种已发表研究结果的分析表明，自杀未遂者的冲动性或抑郁症状等混杂因素在自杀时往往未被考虑在内。脑脊液5-羟吲哚乙酸浓度低与“自杀倾向”和“攻击性”之间看似“有力”的关联实际上相当微弱。报告的自杀行为亚组（如暴力自杀未遂）与脑脊液5-羟吲哚乙酸浓度低之间的关联，很可能是对方法存在缺陷的研究所获结果的某种过早解读。此外，作者认为“自杀行为”是自我攻击行为或内向型攻击的观点，在生物自杀研究中可能并无用处。攻击性的概念定义不充分，导致难以解释实证数据。然而，有证据表明脑脊液5-羟吲哚乙酸浓度降低可能与某些抑郁症状及冲动性变化有关。需要更精心设计的研究来克服现有的方法学缺陷。
