Agren H
Psychiatr Dev. 1983 Spring;1(1):87-103.
One hundred and ten patients with Research Diagnostic Criteria (RDC) diagnoses of major depressive disorders were assessed for present or recent suicidal ideation and behavior and for suicidal acts earlier in life before current depression using the Schedule for Affective Disorders and Schizophrenia (SADS). Suicidal scores were correlated uni- and bivariately with levels of CSF monoamine metabolites (HVA, 5HIAA, MHPG), urinary MHPG, the proportion post-/predexamethasone plasma cortisol at 1100 h, and platelet MAO activity (all standardized to same sex, age, height and weight). Results indicate that all 3 monoamine metabolites and their interactions are involved in various aspects of suicidality, at least in unipolar patients. MHPG and 5HIAA (both low or both high) were involved in current or recent suicidal ideation, and low HVA was mainly associated with past potential lethality of suicidal acts. Current hypercortisolism was found in patients that earlier in life had tried to commit dangerous suicides. Bipolar patients (depressives with a history of manic or hypomanic episodes) had earlier in life significantly more, and more dangerous, suicidal attempts than the unipolars.
使用情感障碍和精神分裂症检查表（SADS），对110名符合研究诊断标准（RDC）的重度抑郁症患者进行评估，以确定其当前或近期的自杀意念和行为，以及在当前抑郁发作之前的早年自杀行为。将自杀得分与脑脊液单胺代谢产物（高香草酸、5-羟吲哚乙酸、3-甲氧基-4-羟基苯乙二醇）水平、尿3-甲氧基-4-羟基苯乙二醇、上午11点时地塞米松给药后/给药前血浆皮质醇比例以及血小板单胺氧化酶活性（均根据性别、年龄、身高和体重进行标准化）进行单变量和双变量相关分析。结果表明，至少在单相抑郁症患者中，所有3种单胺代谢产物及其相互作用都参与了自杀行为的各个方面。3-甲氧基-4-羟基苯乙二醇和5-羟吲哚乙酸（均低或均高）与当前或近期的自杀意念有关，而低高香草酸主要与过去自杀行为的潜在致死性有关。在早年曾试图实施危险自杀行为的患者中发现了当前的皮质醇增多症。双相情感障碍患者（有躁狂或轻躁狂发作史的抑郁症患者）在早年的自杀未遂次数明显多于单相抑郁症患者，且自杀未遂行为更危险。
