کلسترول سرم، رفتار خودکشی و تکانشگری در بیماران وابسته به کوکائین

Relationships between serum cholesterol and suicidal behavior have been reported. As suicidal behavior is common in cocaine dependence, we looked for a relationship with serum cholesterol. To do this, we compared 57 cocaine-dependent patients who had attempted suicide with 111 cocaine-dependent patients who had never attempted suicide for their admission total serum cholesterol levels. We found that there were no significant differences between cocaine-dependent patients who had or had not attempted suicide in their total serum cholesterol levels. Also, there were no significant correlations between total serum cholesterol levels and scores on the Barratt Impulsivity Scale. Thus, admission total serum cholesterol does not appear to be clinically useful in the assessment of suicidal behavior in cocaine-dependent patients.

In recent years relationships between serum cholesterol and suicidal behavior have been reported (reviewed in Golomb, 1998). For example, a 12-year follow-up of men screened for the multiple risk factor intervention trial found that those with cholesterol levels less than 160 mg/dl had a greater risk of suicide than those with levels of 160 mg/dl or higher (Neaton et al., 1992). Similarly, a Swedish seven-year follow-up revealed that the relative risk for suicide was raised for men in the lowest cholesterol group compared to those in the highest cholesterol group (Lindberg et al., 1992). Most recently, a Finnish primary prevention trial of 29 133 men found that low, baseline serum cholesterol was associated with low mood and death from suicide (Partonen et al., 1999). Low serum cholesterol has also been found to be associated with suicidal behavior in patient samples. For example, Gallerani et al. (1995) found that serum cholesterol was significantly lower among 331 patients admitted to hospital because of suicidal behavior than among controls. Golier et al. (1995) reported that low cholesterol was associated with medically serious suicide attempts. Fawcett et al. (1997) found significantly lower cholesterol levels in 49 inpatients who committed suicide in the hospital when compared with two general population control groups. Tanskanen et al. (2000) noted an association between cholesterol and violent suicide. Most recently, we found that 120 overdose patients had significantly lower, serum cholesterol levels than 120 normal controls (Sarchiapone et al., 2001). Patients with a cocaine dependency have a higher risk of suicidal behavior. For example, Marzuk et al. (1992) found that 29% of suicide victims in New York aged 21–30 tested positive for cocaine. Data from 13 673 participants in the epidemiologic catchment area survey in the USA showed that cocaine abusers had a significantly increased risk of attempting suicide (Petronis et al., 1990). Therefore, we decided to examine whether low serum cholesterol was associated with suicidal behavior in cocaine-dependent patients. We hypothesized that cocaine-dependent patients who had attempted suicide would have significantly lower serum cholesterol levels than cocaine-dependent patients who had never attempted suicide.