Biochemical Studies of Suicide

  • Boris Birmaher
  • Laurence L. Greenhill
  • Michael Stanley

Abstract

The incidence of suicide in adolescents has been increasing, making it more and more important to arrive at an accurate diagnosis and to mount effective prevention programs.1 Efforts to construct a behavior profile that predicts risk of attempted or completed suicide have been unsuccessful. Only weak correlations exist at present between suicide and types of premorbid behavior. Current profiles of the child at suicide risk turn up many false-positive results,2 suggesting that available models have low specificity.

Keywords

Depression Dopamine Cortisol Schizophrenia Serotonin 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Curran DK: Adolescent Suicidal Behavior. Hagerstown, Maryland, Harper & Row, 1987, pp 14Google Scholar
  2. 2.
    Cohen J: Statistical approaches to suicidal risk factor analysis, in Stanley M Mann JJ (eds), Psychobiology of Suicidal behavior. New York, New York Academy of Sciences, 1986, pp 34–41Google Scholar
  3. 3.
    Lloyd KG, Farley IJ, Deck JHN, et al : Serotonin and 5-hydroxyindoleacetic acid in discrete areas of the brainstem of suicide victims and control patients, in Advances in Biochemical Psychopharmacology, Vol. II. New York, Raven Press, 1974, pp 387–397Google Scholar
  4. 4.
    Pare CMB, Yeung DPH, Price K, et al : 5-Hydroxytryptamine, noradrenaline and dopamine in brain steam, hypothalamus and caudate nucleus of controls of patients committing suicide by coal-gas poising. Lancet 1:131–135, 1969Google Scholar
  5. 5.
    Shaw DM, Camps FE, Eccleston EG : 5-hydroxytryptamine in the hind brain of depressive suicides. Br J Psychiatry 113:1407–1411, 1967PubMedCrossRefGoogle Scholar
  6. 6.
    Korpi ER, Kleinman JE, Goodman SI, et al : Serotonin and 5-hydroxyindolacetic acid concentrations in different brain regions of suicide victims: Comparison in chronic schizophrenic patients with suicide as cause of death. Presented at theInternational Society of Neurochemistry, Vancouver, Canada 1983Google Scholar
  7. 7.
    Gillin JC, Kelsoe JR, Kaufman CA, et al : Muscarinic receptor density in skin fibroblasts and autopsied brain tissue in affective disorder. Presented atPsychobiology of Suicide Behavior. New York, New York Academy of Sciences, September 1985, pp 143–147Google Scholar
  8. 8.
    Bourne HR, Bunney WE Jr, Colburn RW, et al: Noradrenaline, 5-hydroxytryptamine, and 5-indoleacetic acid in the human brain: Post mortem studies in a group of suicides and in a control group. Lancet 2:805–808, 1968PubMedCrossRefGoogle Scholar
  9. 9.
    Beskow J, Gottfriess GC, Roos BE, et al : Determination of monoamine and monoamine metabolites in the human brain: post mortem studies in a group of suicides and in a control group. Acta Psychiatr Scand 53:7–20, 1976PubMedCrossRefGoogle Scholar
  10. 10.
    Stanley M, Mann JJ : Increased serotonin-2 binding sites in frontal cortex of suicide victims. Lancet 2:214–216, 1983CrossRefGoogle Scholar
  11. 11.
    Crow TJ, Cross AJ, Cooper SJ, et al : Neurotransmitter receptors and monoamine metabolites in the patient with Alzheimer-type dementia and depression and suicides. Neuropharmacology 23:1561–1569, 1984PubMedCrossRefGoogle Scholar
  12. 12.
    Owen F, Cross AJ, Crow TJ, et al : Brain 5-HT2 receptors and suicide. Lancet 2:1256, 1963Google Scholar
  13. 13.
    Grote SS, Moses SG, Robins, E, et al : A study of selected catecholamine metabolizing enzymes: A comparison of depressive suicides and alcoholic suicides with controls. J Neurochem 23:791–236, 1974PubMedCrossRefGoogle Scholar
  14. 14.
    Gottfries, CG, Knorring LV, Oreland L : Platelet monamine oxidase activity in brains from alcoholic. J Neurochem, 25:667–673, 1975PubMedCrossRefGoogle Scholar
  15. 15.
    Mann JJ, Stanley M : Postmortem monoamine oxidase enzyme kinetics in the frontal cortex of suicide victims and controls. Acta Psychiatr Scand 69:135–139, 1984PubMedCrossRefGoogle Scholar
  16. 16.
    Langer SZ, Moret C, Raisman R, et al ; High-affinity [3H]imipramine binding in rat hypothalamus: Association with uptake of serotonin but not of norepinephrine. Science 210:1133–1135, 1980PubMedCrossRefGoogle Scholar
  17. 17.
    Brunello N, Chuang DM, Costa E : Different synaptic location of mianserin and imipramine binding sites. Science 215:1112–1115, 1982PubMedCrossRefGoogle Scholar
  18. 18.
    Rehavi M, Skolnick P, Paul SM : Solubilization and partial purification of the high affinity [3H]imipramine binding site from human platelets. FEBS Lett 150:514–518, 1982PubMedCrossRefGoogle Scholar
  19. 19.
    Raisman R, Sechter D, Briley MS, et al : High affinity 3H-imipramine binding in platelets from untreated and treated depressed patients compared to healthy volunteers. Psychopharmacology 75:368–371, 1981PubMedCrossRefGoogle Scholar
  20. 20.
    Stanley M, Virgilio J, Gershon S : Tritiated imipramine binding sites are decreased in the frontal cortex of suicides. Science 216:1337–1339, 1982PubMedCrossRefGoogle Scholar
  21. 21.
    Paul SM, Rehavi M, Skolnick P, et al : High affinity binding of antidepressants to a biogenic amine transport site in human brain and platelet: Studies in depression, in Post RM Ballenger JC(eds), Neurobiology and Mood Disorders. Baltimore, William & Wilkins, 1984, pp 846–853Google Scholar
  22. 22.
    Meyerson LR, Wennogle LP, Abel MS, et al : Human brain receptor alterations in suicide victims. Pharmacol Biochem Behav 17:159–163, 1982PubMedCrossRefGoogle Scholar
  23. 23.
    Peroutka SJ, Snyder SH : Regulation of serotonin (5-HT2) labeled with [3H] spiroperidol by chronic treatment with antidepressant amitriptyline. Pharmacol Exp Therap 215:582–587, 1980Google Scholar
  24. 24.
    Mann JJ, Stanley M, McBride AP, et al : Increased serotonin and beta-adrenergic receptor binding in the frontal cortices of suicide victims. Arch Gen Psychiatry 43:954–959, 1986PubMedCrossRefGoogle Scholar
  25. 25.
    Meltzer HY, Nash JF, Ohmori T, et al : Neuroendocrine and biochemical studies of serotonin and dopamine in depression and suicide. International Conference on New Directions in Affective Disorders, S60, 1987Google Scholar
  26. 26.
    Cheetham SC, Crompton MR, Katona CLE, Horton RW : Brain 5-HT2 receptor binding sites in depressed suicide victims. Brain Res. 443:272–280, 1988PubMedCrossRefGoogle Scholar
  27. 27.
    Janowsky DS, El-Yousef MK, David JM, et al : A cholinergic-adrenergic hypothesis of mania and depression. Lancet 1:632, 1972CrossRefGoogle Scholar
  28. 28.
    Stanley M : Cholinergic receptor binding in the frontal cortex of suicide victims. Am J Psychiatry 141:1432–1436, 1984PubMedGoogle Scholar
  29. 29.
    Kaufman CA, Gillin JC, Hill B, et al : Muscarinic binding sites in suicides. Psychiatry Res 12:47–55, 1984CrossRefGoogle Scholar
  30. 30.
    Sulser F, Robonson SE : Clinical implications of pharmacological differences among antipsychotic drugs, In Lipton MA DiMascio A Killam KF(eds), Psychopharmacology: A Generation of Progress. New York, Raven, 1978, pp 943–954Google Scholar
  31. 31.
    Zanko MT, Biegon A : Increased p-adrenergic receptor binding in human frontal cortex of suicide victims. Abstract of theAnnual Meeting, Society of Neuroscience, Boston, 1983Google Scholar
  32. 32.
    Biegon A : Findings in beta receptors in suicide victims. Grand Rounds, Rockefeller University, June 1987Google Scholar
  33. 33.
    Nemeroflf CB, Widerlow E, Bissett G, et al: Arch Gen Psychiatry, 45:577–579, 1988CrossRefGoogle Scholar
  34. 34.
    Ashby P, Verrier M, Wash JJ, et al : Spinal reflexes and the concentrations of 5-HIAA, MHPG and HVA in lumbar cerebrospinal fluid after spinal lesions in man. J Neurol Neurosurg Psychiatry 39:1191–1200, 1976PubMedCrossRefGoogle Scholar
  35. 35.
    Curzon G, Gumpert EJ, Sharpe DM : Amine metabolites in the lumbar cerebrospinal fluid of humans with restricted flow of cerebrospinal fluid. Nature New Biol 231:189–191, 1971PubMedGoogle Scholar
  36. 36.
    Post RM, Goodwin FK, Gordon E, et al : Amine metabolites in human cerebrospinal fluid: Effects of cord transection and spinal fluid block. Science 179:897–899, 1973PubMedCrossRefGoogle Scholar
  37. 37.
    Stanley M, Traskman-Bendz L, Dorovini-Zis K : Correlations between aminergic metabolites simultaneously obtained from human CSF and brain. Life Sci 37:1279–1286, 1985PubMedCrossRefGoogle Scholar
  38. 38.
    Asberg M, Thoren P, Traskman L, et al: Serotonin depression: A biochemical subgroup within the affective disorders? Science 191:478–480, 1976PubMedCrossRefGoogle Scholar
  39. 39.
    Asberg M, Traskman L, Birtilson L, et al : Studies of CSF 5-HIAA in depression and suicidal behavior. Exp Med Biol 133:739–752, 1981Google Scholar
  40. 40.
    Agren H : Symptom patterns in unipolar and bipolar depression correlating with monoamine metabolites in the cerebrospinal fluid. II. Suicide Psychiatry Res 3:225–236, 1980Google Scholar
  41. 41.
    Van Praag HM : Depression, suicide and the metabolism of serotonin in the brain. J Affective Dis 4:275–290, 1982CrossRefGoogle Scholar
  42. 42.
    Banki CM, Arato M, Papp Z, et al : Biochemical markers in suicidal patients: Investigations with cerebrospinal fluid amine metabolites and neuroendocrine tests. J Affective Dis 6:341–350, 1984CrossRefGoogle Scholar
  43. 43.
    Palanappian V, Ramachandran V, Somasundaram O : Suicidal ideation and biogenic amines in depression. Indian J Psychiatry 25:268–292, 1983Google Scholar
  44. 44.
    Montgomery SA, Montgomery D : Pharmacological prevention of suicidal behavior. J Affective Dis 4:291–298, 1982CrossRefGoogle Scholar
  45. 45.
    Perez de los Cobos JZ, Lopez-Ibor Alino JJ, Saiz Ruiz J : Correlatos biologicaos del suicido y la agresivivad en depressiones mayores (con melancholia): 5-HIAA en LCR, DST, y respuesta terapeutica a 5-HTP. Presented at the First Congress of the Spanish Society for Biological Psychiatry, Barcelona, 1984Google Scholar
  46. 46.
    Brown GL, Goodwin FK, Ballenger JC, et al : Aggression in humans correlates with cerebrospinal fluid amine metabolism. Psychiatry Res 1:131–139, 1979PubMedCrossRefGoogle Scholar
  47. 47.
    Brown GL, Ebert MH, Goyer PF, et al : Aggression, suicide and serotonin; relationships to CSF amine metabolites. Am J Psychiatry 139:741–746, 1982PubMedGoogle Scholar
  48. 48.
    Traskman L, Asberg M, Bertillsson K, et al : Monoamine metabolites in CSF and suicidal behavior. Arch Gen Psychiatry 38:631–636, 1981PubMedCrossRefGoogle Scholar
  49. 49.
    Linnoila M, Virkkunen M, Scheinin M, et al : Low cerebrospinal fluid 5-hydroxyindoleacetic acid concentrations differentiates impulsive violent behavior. Life Sci 33:2609–2614, 1983PubMedCrossRefGoogle Scholar
  50. 50.
    Van Praag HM : CSF 5-HIAA and suicide in non-depressed schizophrenics. Lancet 2:977–978, 1984Google Scholar
  51. 51.
    Ninan PT, Van Kammen DP, Scheinin M, et al : CSF 5-hydroxyindoleacetic acid in suicidal schizophrenic patients. Am J Psychiatry 141:566–569, 1984PubMedGoogle Scholar
  52. 52.
    Miles CL : Conditions predisposing to suicide. J Nerv Ment Dis 164:231–246, 1977PubMedCrossRefGoogle Scholar
  53. 53.
    Tsuang MT : Suicide in schizophrenics, manics, depressives, and surgical controls. Arch Gen Psychiatry 35:153–155, 1978PubMedCrossRefGoogle Scholar
  54. 54.
    Roy A : Suicide in chronic schizophrenics. Br J Psychiatry 144:171–177, 1982CrossRefGoogle Scholar
  55. 55.
    Roy A, Ninam P, Mazonson A, et al : CSF monoamine metabolite in chronic schizophrenia patients who attempt suicide. Psychol Med 15:335–340, 1985PubMedCrossRefGoogle Scholar
  56. 56.
    Pickar D, Roy A, Brier A, et al : Suicide and aggression in schizophrenia: neurobiologic correlates, in Mann JJ Stanley M(eds), Psychobiology of Suicidal Behavior. New York, New York Academy of Sciences, 1986, pp 189–196Google Scholar
  57. 57.
    Jamison KR : Suicide and bipolar disorders, in Mann JJ Stanley M(eds), Psychobiology of Suicidal Behavior. New York, New York Academy of Sciences, 1986, pp 301–315Google Scholar
  58. 58.
    Roy-Byme P, Post RM, Rubinow DR, et al : CSF 5-HIAA and personal and family history of suicide in affectively ill patients: a negative study. Psychiatry Res 10:263–274, 1983CrossRefGoogle Scholar
  59. 59.
    Berrettini W, Nurenberger J, Narrow W, et al : Cerebrospinal fluid studies of bipolar patients with and without a history of suicide attempts, in Mann JJ Stanley M(eds): Psychobiology of Suicidal Behavior. New York, New York Academy of Sciences, 1986, pp 197–201Google Scholar
  60. 60.
    Goodwin FK : Suicide aggression and depression: A theoretical framework for future research, in Mann JJ Stanley M(eds), Psychobiology of Suicidal Behavior. New York, New York Academy of Sciences, 1986, pp 351–356Google Scholar
  61. 61.
    Banki C, Arato M, Kilts C : Aminergic studies and cerebrospinal fluid cautions in suicide, in Mann JJ Stanley M(eds), Psychobiology of Suicidal Behavior. New York, New York Academy of Sciences, 1986, pp 221–230Google Scholar
  62. 62.
    Banki C : Factors influencing monoamine metabolites and tryptophan in patients with alcohol dependence. J Neural Transm 50:98–101, 1981CrossRefGoogle Scholar
  63. 63.
    Ballenger JC, Goodwin FK, Major LF, et al : Alcohol and central serotonin metabolism in man. Arch Gen Psychiatry 36:224–227, 1979PubMedCrossRefGoogle Scholar
  64. 64.
    Tabakoff B, Ritzmann R : Inhibition of the transport of 5-hydroxyindoleacetic acid from brain by ethanol. J Neurochem 24:1043–1051, 1975PubMedCrossRefGoogle Scholar
  65. 65.
    Ellingboe J : Effect of alcohol on neurochemical processes, in Lipton M DiMascio A Killman K(eds), Psychopharmacology: A Generation of Progress. New York, Raven, 1978, pp 1653–1654Google Scholar
  66. 66.
    Herrero E : Monoamine metabolism in rat brain regions following long-term alcohol treatment. J Neural Transm 47:227–236, 1980CrossRefGoogle Scholar
  67. 67.
    Secunda JA, Cross CK, Koslow K, et al : Biochemistry and suicidal behavior in depressed patients. Biol Psychiatry 21:756–767, 1986PubMedCrossRefGoogle Scholar
  68. 68.
    Oreland L, Wilberg A, Asberg M, et al : Platelet MAO activity and monoamine metabolites in cerebrospinal fluid in depressed and suicidal patients and in healthy controls. Psychiatry Res 4:21–29, 1981PubMedCrossRefGoogle Scholar
  69. 69.
    Arato M, Banki CM, Nemeroff CB, et al : Hypothalamic-pituitary-adrenal axis and suicide, in Mann JJ Stanley M, (eds), Psychobiology of Suicidal Behavior. New York, New York Academy of Sciences, 1986, pp 263–270Google Scholar
  70. 70.
    Stoff D, Pollack L, Bridger WL : Platelet imipramine binding sites correlate with aggression in adolescents. Biol Psychiatry 12:180–182, 1986Google Scholar
  71. 71.
    Shaffer D, Bacon K : A critical review of prevention intervention efforts in suicide with particular preference to youth suicide. Prepared for thePrevention and Intervention Work Group of HHS Task Force on Youth Suicide. Presented inOakland, California, June 11–13, 1986Google Scholar
  72. 72.
    Grottfries CG, Knorring LV, Oreland L : Platelet monamine oxidase activity in mental disorders. Neuropsychopharmacology 4:185–192, 1980CrossRefGoogle Scholar
  73. 73.
    Buchsbaum MS, Hairr RJ, Murphy DL : Suicide attempts, platelet monoamine oxidase and the average evoked response. Acta Psychiatry Scand 56:69–77, 1979CrossRefGoogle Scholar
  74. 74.
    Meltzer HY, Arora RC : Platelet markers of suicidality, in Mann JJ Stanley M(eds), Psychobiology of Suicidal Behavior. New York, New York Academy of Sciences, 1986, pp 271–280Google Scholar
  75. 75.
    Bunney WE Jr, Fawcett JA, Davis JM, et al: Possibility of a biochemical test for suicidal potential. Arch Gen Psychiatry 13:232–239, 1965PubMedCrossRefGoogle Scholar
  76. 76.
    Bunney WE Jr, Fawcett JA, Davis JM, et al: Further evaluation of urinary 17-hydroxycorticosteroids in suicidal patients. Arch Gen Psychiatry 21:138–150, 1969PubMedCrossRefGoogle Scholar
  77. 77.
    Ostroff R, Giller E, Bonese K, et al : Neuroendocrine risk factors of suicide. Am J Psychiatry 139:1323–1325, 1982PubMedGoogle Scholar
  78. 78.
    Levy B, Hensen E : Failure of the urinary test for suicidal potential. Arch Gen Psychiatry 20:415–418, 1969PubMedCrossRefGoogle Scholar
  79. 79.
    Carroll BJ, Greden JF, Feinberg M : Suicide, neuroendocrine dysfunction and CSF 5-HIAA concentrations in depression, in Angrist B (ed), Recent Advances in Neuropsychopharmacology. Oxford, Pergamon, 1981, pp 307–313Google Scholar
  80. 80.
    Kocsis JH, Kennedy S, Brown RP, et al : Neuroendocrine studies in depression: Relationship to suicidal behavior, in Mann JJ Stanley M(eds), Psychobiology of Suicidal Behavior. New York, New York Academy of Sciences, 1986, pp 256–262Google Scholar
  81. 81.
    Targum SD, Rosen L, Capodanno AE : The dexamethasone suppression test in suicidal patients with unipolar depression. Am J Psychiatry 140:877–879, 1983PubMedGoogle Scholar
  82. 82.
    Banki CM, Aroto M : Amine metabolites and neuroendocrine responses related to depression and suicide. J Affective Disord 5:223–232, 1983CrossRefGoogle Scholar
  83. 83.
    Van Waltere JP, Charles G, Wilmotte J : Tests de function a la dexamethasome et suicide. Acta Psychiatr Scand 83:569–578, 1983Google Scholar
  84. 84.
    Meltzer HY, Perline R, Tricou BJ, et al : Affect of 5-hydroxytryptophan on serum cortisol levels in major affective disorders. II. Relation to suicide, psychosis and depressive symptoms. Arch Gen Psychiatry 41:379–387, 1984PubMedCrossRefGoogle Scholar
  85. 85.
    Cocarro EF, Siever LJ, Klar H, et al : Serotonergic studies in patients with affective and personality disorders. Arch Gen Psychiatry 46:587–599, 1989CrossRefGoogle Scholar
  86. 86.
    Stanley MM, Mann JJ : Biological factors associated with suicide, in Frances AJ and Hales RE, APA Review of Psychiatry, Vol. 7, 1987, pp 334–352Google Scholar
  87. 87.
    Valzelli L : Psychobiology of Aggression and Violence. New York, Raven, 1981Google Scholar
  88. 88.
    Cochran E, Robins E, Grote S : Regional serotonin levels in brain: A comparison of depressive suicides and alcoholic suicides with controls. Biol Psychiatry 11:283–295, 1976PubMedGoogle Scholar
  89. 89.
    Beskow J, Gottfries CG, Roos BE, et al : Determination of monoamine and monoamine metabolites in the human brain: Postmortem studies in a group of suicides and in a control group. Acta Psychiatr Scand 53:7–20, 1976PubMedCrossRefGoogle Scholar
  90. 90.
    Bourse HR, Bunney WE Jr, Colburn RW, et al: Noradrenadine, 5-hydroxyindoleacetic acid of suicidal patients. Lancet ii:805–808, 1968Google Scholar
  91. 91.
    Korpi ER, Kleinman JE, Goodman SI, et al : Serotonin and 5-hydroxyindoleacetic acid concentrations in different brain regions of suicide victims: Comparison in chronic Schizophrenic patients with suicide as cause of death. Presented at theInternational Society for Neurochemistry, Vancouver, Canada, 1983Google Scholar
  92. 92.
    Crow TJ, Cross AJ, Cooper SJ, et al : Neurotransmitter receptors and monoamine metabolites in the patients with alzheimer-type dementia and depression and suicides. Neuropharmacology 23:1561–1569, 1984PubMedCrossRefGoogle Scholar
  93. 93.
    Perry EK, Marshall EF, Blessed G, et al : Decreased imipramine binding in the brains of patients with depresseve illness. Br J Psychiatry 142:188–192, 1983PubMedCrossRefGoogle Scholar
  94. 94.
    Owens F, Cross AJ, Crow TJ, et al : Brain 5-HT receptors and suicide. Lancet 2:1283, 1983Google Scholar
  95. 95.
    Zanko MT, Biegon A : Increased B-adrenergic receptor binding in human frontal cortex of suicide victims. Abstr. of theAnnual Meeting, Society of Neuroscience, Boston, 1983Google Scholar
  96. 96.
    Mann JJ, Stanley M, McBride AP, et al : Increased serotonin and beta-adrenergic receptor binding in the frontal orifices of suicide victims. Arch Gen Psychiatry 43:954–959, 1986PubMedCrossRefGoogle Scholar
  97. 97.
    Traskman L, Asberg M, Bertilsson K, et al : Monoamine metabolites in CSF and suicidal behavior. Arch Gen Psychiatry 38:631–636, 1987CrossRefGoogle Scholar
  98. 98.
    Montgomery SA, Montgomery D : Pharmacological prevention of suicidal behavior. J Affective Disord 4:291–298, 1982CrossRefGoogle Scholar
  99. 99.
    Palanappian V, Rauachandler V, Somosundaran O : Suicidal ideation and biogenic amines in depression. Indian J Psychiatry 25:268–292, 1983Google Scholar
  100. 100.
    Banki CM, Arato M, Papp Z, et al : Biochemical markers in suicidal patients: Investigations with cerebrospinal fluid amine metabolites and neuroendocrine tests. J Affective Disord 6:341–350, 1984CrossRefGoogle Scholar
  101. 101.
    Perez de los Cobos JZ, Lopez-Ibor Alino JJ, Saiz Ruiz J : Correlatos biologicos del suicido y la agresividad en depressiones mayores (con melancolia): 5-HIAA en LCR, DST, y respuesto terapeutica a 5-HTp. Presented to the first Congress of the Spanish Society for Biological Psychiatry, Barcelona, 1984Google Scholar
  102. 102.
    Berrettini W, Nurenberger J, Narrow W, et al. : Cerebrospinal fluid studies of bipolar patients with and without a history of suicide attempts, in Mann JJ Stanley M(eds), Psychobiology of Suicidal Behavior, New York, New York Academy of Sciences, 1986Google Scholar
  103. 103.
    Van Praag HM : CSF 5-HIAA and suicide in nondepressed schizophrenics. Lancet 2:977–978, 1983PubMedCrossRefGoogle Scholar
  104. 104.
    Ninan PT, Van Kammen DP, Scheinin M, et al : CSF 5-hydroxyindoleacetic acid in suicidal schizophrenic patients. Am J Psychiatry 141:566–569, 1984PubMedGoogle Scholar
  105. 105.
    Stanley M, Stanley B, Traskman-Bendz L, Winchel R, and Jones JS : An assessment of the biochemical findings in schizophrenic patients who attempt suicide. Athens, Greece, VIII World Congress of Psychiatry, Abstract, 1989Google Scholar
  106. 106.
    Banki CM, Alato M : Amine metabolites and neuroendocrine responses related to depression and suicide. J. Affective Disord 5:225–232, 1983CrossRefGoogle Scholar
  107. 107.
    Brown GL, Goodwin FK, Ballenger, JC, et al : Ag ression in humans correlates with cerebrospinal fluid amine metabolites. Psychiatry Res. 1:131–139, 1979PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1990

Authors and Affiliations

  • Boris Birmaher
    • 1
  • Laurence L. Greenhill
    • 2
  • Michael Stanley
    • 3
    • 4
  1. 1.Department of Child PsychiatryCollege of Physicians and Surgeons of Columbia UniversityNew YorkUSA
  2. 2.Department of Clinical PsychiatryCollege of Physicians and Surgeons of Columbia UniversityNew YorkUSA
  3. 3.Departments of Psychiatry and PharmacologyCollege of Physicians and Surgeons of Columbia UniversityNew YorkUSA
  4. 4.Department of NeurochemistryNew York State Psychiatric InstituteNew YorkUSA

Personalised recommendations