Mann J J, Malone K M, Sweeney J A, Brown R P, Linnoila M, Stanley B, Stanley M
MHCRC for the Study of Suicidal Behavior, College of Physicians and Surgeons, Columbia University, New York, USA.
Neuropsychopharmacology. 1996 Dec;15(6):576-86. doi: 10.1016/S0893-133X(96)00102-9.
Serotonin abnormalities have been reported in the brain of suicide victims. Evidence of a serotonin deficiency in suicide attempters is less consistent. We hypothesized that a serotonin deficiency may be present in suicide attempters whose attempt behavior more closely approximates completed suicide.
Sixty-seven (67) drug-free depressed inpatients (46 suicide attempters, 21 nonattempters) underwent research clinical assessments and a lumbar puncture. Cerebrospinal fluid (CSF) monoamine metabolites were assayed. Degree of medical damage and intent of the most recent suicide attempt were rated.
CSF amine metabolites did not differentiate suicide attempters as a group from nonattempters. However, reduced serotonergic activity, as indicated by lower levels of CSF-5-hydroxyindoleacetic acid (5-HIAA) was associated with a history of planned suicide attempts and with suicide attempts that resulted in greater medical damage. Other monoamine metabolites did not correlate with seriousness of suicidal behavior, except for low CSF homovanillic acid and higher medical damage. No correlation was found with violent method.
Planned and more medically damaging suicide attempts appear to be associated specifically with low serotonergic activity and, therefore, resemble completed suicide both behaviorally and biochemically. It remains to be determined whether low levels of CSF 5-HIAA can predict greater medical damage in future suicide attempts.
已有报道称自杀受害者大脑中存在血清素异常。而自杀未遂者中血清素缺乏的证据则不太一致。我们推测，在那些自杀未遂行为更接近成功自杀的自杀未遂者中可能存在血清素缺乏的情况。
67名未服用药物的抑郁症住院患者（46名自杀未遂者，21名未尝试自杀者）接受了研究临床评估和腰椎穿刺。对脑脊液（CSF）单胺代谢产物进行了检测。对医疗损伤程度和最近一次自杀未遂的意图进行了评分。
脑脊液胺代谢产物并不能将自杀未遂者作为一个群体与未尝试自杀者区分开来。然而，脑脊液5-羟吲哚乙酸（5-HIAA）水平较低所表明的血清素能活性降低与有计划的自杀未遂史以及导致更大医疗损伤的自杀未遂有关。除了脑脊液高香草酸水平低和医疗损伤较大外，其他单胺代谢产物与自杀行为的严重程度无关。未发现与暴力方式有相关性。
有计划的、对医疗损伤更大的自杀未遂似乎与血清素能活性低有特定关联，因此在行为和生化方面与成功自杀相似。脑脊液5-HIAA水平低是否能预测未来自杀未遂中更大的医疗损伤仍有待确定。
