CSF 5-HIAA and DST non-Suppression – Orthogonal Biologic Risk Factors for Suicide in Male Mood Disorder Inpatients

This investigation examined the interrelation of low CSF 5-HIAA & DST non-suppression in suicide victims with mood disorder. 58 mood disorder inpatients not receiving any treatment with antidepressants underwent lumbar puncture & the DST. Plasma cortisol levels at 3 time points were analysed in relation to CSF 5-HIAA. During follow-up (mean 21 years), 11 patients had died by suicide. In the 6 male victims, the serum cortisol level at 4:00 p.m. showed a significant positive correlation with CSF 5-HIAA. Low CSF 5-HIAA predicted all early suicides (within 1 year), whereas all males who died by suicide after 1 year were DST non-suppressors. In the 5 female victims, the post-DST serum cortisol did not correlate with CSF 5-HIAA. (40 refs.)