Stefansson Jon, Chatzittofis Andreas, Nordström Peter, Arver Stefan, Åsberg Marie, Jokinen Jussi
Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden.
Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Psychoneuroendocrinology. 2016 Dec;74:1-6. doi: 10.1016/j.psyneuen.2016.08.009. Epub 2016 Aug 20.
Very few studies have assessed testosterone levels in the cerebrospinal fluid in suicide attempters. Aggressiveness and impulsivity are common behavioural traits in suicide attempters. Dual-hormone serotonergic theory on human impulsive aggression implies high testosterone/cortisol ratio acting on the amygdala and low serotonin in the prefrontal cortex. Our aim was to examine the CSF and plasma testosterone levels in suicide attempters and in healthy volunteers. We also assessed the relationship between the testosterone/cortisol ratio, aggressiveness and impulsivity in suicide attempters. 28 medication-free suicide attempters and 19 healthy volunteers participated in the study. CSF and plasma testosterone sulfate and cortisol levels were assessed with specific radio-immunoassays. The Karolinska Scales of Personality was used to assess impulsivity and aggressiveness. All patients were followed up for cause of death. The mean follow-up period was 21 years. Male suicide attempters had higher CSF and plasma testosterone levels than age- matched male healthy volunteers. There were no significant differences in CSF testosterone levels in female suicide attempters and healthy female volunteers. Testosterone levels did not differ significantly in suicide victims compared to survivors. In male suicide attempters, the CSF testosterone/cortisol ratio showed a significant positive correlation with both impulsivity and aggressiveness. Higher CSF testosterone levels may be associated with attempted suicide in young men through association with both aggressiveness and impulsivity, a key endophenotype in young male suicide attempters.
极少有研究评估过自杀未遂者脑脊液中的睾酮水平。攻击性和冲动性是自杀未遂者常见的行为特征。关于人类冲动性攻击行为的双激素血清素能理论认为，高睾酮/皮质醇比值作用于杏仁核，而前额叶皮质中的血清素水平较低。我们的目的是检测自杀未遂者和健康志愿者脑脊液及血浆中的睾酮水平。我们还评估了自杀未遂者睾酮/皮质醇比值与攻击性和冲动性之间的关系。28名未服用药物的自杀未遂者和19名健康志愿者参与了这项研究。采用特异性放射免疫分析法评估脑脊液和血浆中硫酸睾酮及皮质醇水平。使用卡罗林斯卡个性量表评估冲动性和攻击性。对所有患者进行死因随访。平均随访期为21年。男性自杀未遂者的脑脊液和血浆睾酮水平高于年龄匹配的男性健康志愿者。女性自杀未遂者与健康女性志愿者的脑脊液睾酮水平无显著差异。与幸存者相比，自杀死亡者的睾酮水平无显著差异。在男性自杀未遂者中，脑脊液睾酮/皮质醇比值与冲动性和攻击性均呈显著正相关。脑脊液中较高的睾酮水平可能通过与攻击性和冲动性相关联，而与年轻男性自杀未遂有关，攻击性和冲动性是年轻男性自杀未遂者的关键内表型。
