Recent biologic studies on suicide.

This paper selectively reviews the author's recent studies on suicidal behavior in depression. Data are reviewed from a study of depressed patients who had monoamine metabolites measured in both the cerebrospinal fluid (CSF) and urine. Depressed patients who had attempted suicide had significantly reduced CSF concentrations of the dopamine metabolite homovanillic acid (HVA) and significantly lower urinary outputs of HVA than patients who had not attempted suicide. Similarly, patients who went on to reattempt suicide over a 5-year follow-up period had both significantly reduced CSF concentrations of HVA and lower urinary outputs of HVA than patients who did not reattempt. These data suggest a role for diminished central dopaminergic neurotransmission in suicidal behavior in depression. Patients who had made a violent suicide attempt also showed evidence of dysregulation of the hypothalamic-pituitary-adrenal axis.