Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-25T14:18:20.343Z Has data issue: false hasContentIssue false
  • English
  • Français

Biological markers for suicidal behavior in alcohol dependence

Published online by Cambridge University Press:  16 April 2020

P. Gorwood
P. Gorwood*
Affiliation:
Hôpital Louis Mourier (AP-HP), Service de Psychiatrie, 178 rue des Renouillers, 92700 Colombes; CNRS UMR 7593-Paris VII, Personnalité et conduites adaptatives, CHU Pitié-Salpêtrière, 75013Paris, France
*
*Correspondence and reprints. E-mail address: [email protected] (P. Gorwood).
Get access

Summary

Alcohol-dependent populations have a high lifetime suicide rate (between 7 and 15%, relative risk = 7), and alcoholism is one of the two psychiatric disorders most frequently found in suicidal cases (between 15 and 25%). Biological factors that would detect patients at risk could thus be of value. Carbohydrate-deficient transferrin, monoamine oxydase B, soluble interleukin-2 receptor and cholesterol have been proposed as markers of suicidal risk in alcohol-dependent patients, although nonspecific and with low predictive value. On the other hand, there is large and convergent data stressing the importance of serotonin dysregulation as increasing the risk for aggressive behaviour toward the self, although it is not clear whether serotonin is involved through the altered behavior inhibition system, enhancement of anxiety and depression, or association with specific subtypes of alcohol-dependence, such as early-onset type II alcoholism. Considering the complex but significant impact of alcohol on serotonin metabolism and turnover, it is likely that serotonin mediates a large part of the proneness of ethanol to commit impulsive-aggressive behavior.

Keywords

alcoholdependencemortalityserotoninsuicide
Type
Original article
Information
European Psychiatry , Volume 16 , Issue 7 , November 2001 , pp. 410 - 417
Copyright
Copyright © European Psychiatric Association 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Asberg, MTräskman, LThorén, P.5-HIAA in the cerebrospinal fluid – a biochemical suicide predictor?. Arch Gen Psychiatry 1976; 33: 1193–7.CrossRefGoogle ScholarPubMed
Badawy, AEvans, M.The role of free serum tryptophan in the biphasic effect of acute ethanol administration on the concentration of rat brain tryptophan, 5-hydroxytryptamine and 5-hydroxyindol-3-acetic acid. Biochem J 1976; 160: 315–24.CrossRefGoogle Scholar
Badawy, A.Alcohol, aggression and serotonin: metabolic aspects. Alcohol Alcohol 1998; 33: 66–72.CrossRefGoogle ScholarPubMed
Ballenger, JGoodwin, FMajor, LBrown, G.Alcohol and central serotonin metabolism in man. Arch Gen Psychiatry 1979; 36: 224–7.CrossRefGoogle ScholarPubMed
Banki, CArato, MPapp, ZKurcz, M.Biochemical markers in suicidal patients. J Affective Disord 1984; 6: 341–50.CrossRefGoogle ScholarPubMed
Banki, C.Factors influencing monoamine metabolites and tryptophan in patients with alcohol dependence. J Neural Transm 1981; 50: 89–101.CrossRefGoogle ScholarPubMed
Barraclough, BBunch, JNelson, BSainsbury, P.A hundred cases of suicide: Clinical aspects. Br J Psychiatry 1974; 125: 355–73.CrossRefGoogle ScholarPubMed
Beck, OBorg, SEdman, GFyrö, BOxenstierna, G.Sedvall G. 5-Hydroxytryptophol in human cerebrospinal fluid: conjugation, concentration gradient, relationship to 5-hydroxyindoleacetic acid, and influence on hereditary factors. J Neurochem 1984; 43: 58–61.CrossRefGoogle ScholarPubMed
Bellivier, FSzöke, AHenry, C. et al. Possible association between serotonin transporter gene polymorphism and violent suicidal behavior in mood disorders. Biol Psychiatry 2000; 48: 319–22.CrossRefGoogle ScholarPubMed
Berglund, M.Suicide in alcoholism: a prospective study of 88 suicides. I. The multidimensional diagnosis at first admission. Arch Gen Psychiatry 1984; 41: 888–91.CrossRefGoogle Scholar
Chignon, JMCortes, MJMartin, PChabannes, JP.Attempted suicide and alcohol dependence: results of an epidemiologic survey. Encephale 1998; 24: 347–54.Google ScholarPubMed
Cleare, ABond, A.The effect of tryptophan depletion and enhancement on subjective and behavioral aggression in normal male subjects. Psychopharmacology 1995; 118: 72–81.CrossRefGoogle ScholarPubMed
Cloninger, CR.Neurogenetic adaptative mechanisms in alcoholism. Science 1987; 236: 410–6.CrossRefGoogle Scholar
Cornelius, JSalloum, IMezzich, JCornelius, MFabrega, HEhler, J. et al. Disproportionate suicidality in patients with comorbid major depression and alcoholism. Am J Psychiatry 1995; 152: 358–64.Google ScholarPubMed
Courtet, PBaud, PAbbar, MBoulenger, JPCastelnau, DMouthon, D. et al. Association between violent suicidal behavior and the low activity allele of the serotonin transporter gene. Mol Psychiatry 2001; 6: 338–41.CrossRefGoogle ScholarPubMed
Crabbe, JPhillips, TFeller, DHen, RWenger, CLessov, C. et al. Elevated alcohol consumption in null mutant mice lacking 5-HT1B serotonin receptors. Nat Genet 1996; 14: 98–101.CrossRefGoogle ScholarPubMed
Dougherty, DMBjork, JMMarsh, DMMoeller, FG.Influence of trait hostility on tryptophan depletion-induced laboratory aggression. Psychiatry Res 1999; 29: 227–32.CrossRefGoogle Scholar
Ernouf, DCompagnon, PLothion, PNarcisse, GBénard, JYDaoust, M.Platelets 3H 5-HT uptake in descendants from alcoholic patients: a potential risk factor for alcohol dependence. Life Sci 1993; 52: 989–95.CrossRefGoogle ScholarPubMed
Fils-Aime, MEckhardt, MGeorge, DBrown, GMefford, ILinnoila, M.Early-onset alcoholics have lower cerebrospinal fluid 5-hydroxyindoleacetic acid levels than late-onset alcoholics. Arch Gen Psychiatry 1996; 53: 211–6.CrossRefGoogle ScholarPubMed
Friedman, MJKrstulovic, AMSeveringhaus, JMBrown, SJ.Altered conversion of tryptophan to kynurenine in newly abstinent alcoholics. Biol Psychiatry 1988; 23: 89–93.CrossRefGoogle ScholarPubMed
Golier, JAMarzuk, PMLeon, ACWeiner, CTardiff, K.Low serum cholesterol level and attempted suicide. Am J Psychiatry 1995; 152: 419–23.Google ScholarPubMed
Golomb, BAStattin, HMednick, S.Low cholesterol and violent crime. J Psychiatr Res 2000; 34: 301–9.CrossRefGoogle ScholarPubMed
Gorwood, PAissi, FBatel, PAdès, JHamon, MBoni, C. et al. Reappraisal of the serotonin 5-HT1B receptor gene in alcoholism: “Of mice and men”. Brain Research Bulletin. in press.Google Scholar
Gorwood, PBatel, PAdès, JHamon, MBoni, C.Serotonin transporter gene polymorphisms, alcoholism and suicidal behaviour. Biol Psychiatry 2000; 48: 259–64.CrossRefGoogle Scholar
Gruenewald, PPonicki, WMitchell, P.Suicide rates and alcohol consumption in the United States, 1970–89. Addiction 1995; 90: 1063–75.CrossRefGoogle ScholarPubMed
Hawton, KFagg, JMcKeown, S.Alcoholism, alcohol, and attempted suicide. Alcohol Alcohol 1989; 24: 3–9.Google ScholarPubMed
Heinz, AMann, KWeinberger, DGoldman, D.Serotoninergic dysfunction, negative mood states, and response to alcohol. Alcohol Clin Exp Res 2001; 4: 487–95.CrossRefGoogle Scholar
Heinz, ARagan, PJones, DWHomner, DWilliams, WKnable, MB. et al. Reduced central serotonin transporters in alcoholism. Am J Psychiatry 1998; 155: 1544–9.CrossRefGoogle ScholarPubMed
Hesselbrock, MHesselbrock, VSyzmanski, KWeidenman, M.Suicide attempts and alcoholism J Stud Alcohol 1988; 49: 436–42.CrossRefGoogle ScholarPubMed
Higley, JDMehlman, PTPoland, RETaub, DMVickers, JSuomi, SJ. et al. CSF testosterone and 5-HIAA correlate with different types of aggressive behaviors. Biol Psychiatry 1996; 40: 1067–82.CrossRefGoogle ScholarPubMed
Hsu, YPLoh, EWChen, WJChen, CCYu, JMCheng, AT.Association of monoamine oxidase A alleles with alcoholism among male Chinese in Taiwan. Am J Psychiatry 1996; 153: 1209–11.Google ScholarPubMed
Inskip, HMHarris, ECBarraclough, B.Lifetime risk of suicide for affective disorder, alcoholism and schizophrenia. Br J Psychiatry 1998; 172: 35–7.CrossRefGoogle Scholar
Iribarren, CReed, DMWergowske, GBurchfiel, CMDwyer, JH.Serum cholesterol level and mortality due to suicide and trauma in the Honolulu Heart Program. Arch Intern M 1995; 155: 695–700.CrossRefGoogle ScholarPubMed
Juo, SHPugh, EWBaffoe-Bonnie, AKingman, ASorant, AJKlein, AP. et al. Possible linkage of alcoholism, monoamine oxidase activity and P300 amplitude to markers on chromosome 12q24. Genet Epidemiol 1999; 17: S193–8.CrossRefGoogle ScholarPubMed
Kaplan, JMartin, LComuzzie, AManuck, SMann, JRogers, J.Heritability of monoaminergic metabolites measured in the cerebrospinal fluid of baboons. Soc Neurosci Abstr 2000; 26: 1439.Google Scholar
Kaplan, JRShively, CAFontenot, MBMorgan, TMHowell, SMManuck, SB. et al. Demonstration of an association among dietary cholesterol, central serotonergic activity, and social behavior in monkeys. Psychosom M 1994; 56: 479–84.CrossRefGoogle ScholarPubMed
Kessler, RMcGonagle, KZhao, SNelson, CHughes, MEshleman, S. et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders among persons aged 15–54 in the United Sates: results from ther National Comorbidity Survey. Arch Gen Psychiatry 1994; 51: 8–19.CrossRefGoogle Scholar
Knutson, BWolkowitz, OCloe, SMoore, EJohnson, RTerpstra, J. et al. Selective alteration of personality and social behavior by serotoninergic intervention. Am J Psychiatry 1998; 155: 373–9.CrossRefGoogle Scholar
Lappalainen, JLong, JCEggert, MOzaki, NRobin, RWBrown, GL. et al. Linkage of antisocial alcoholism to the serotonin 5-HT1B receptor gene in 2 populations. Arch Gen Psychiatry 1998; 55: 989–94.CrossRefGoogle ScholarPubMed
Lester, D.Alcoholism and drug abuse. Maris, RWBerman, ALMaltsberger, JTYufit, RI, Eds.; Assessment and prediction of suicide. New York: Guilford Press; 1992. 321–36.Google Scholar
Lester, D.The association between alcohol consumption and suicide and homicide rates: a study of 13 nations. Alcohol Alcohol 1995; 30: 465–8.Google ScholarPubMed
Little, KYMcLaughlin, DPZhang, LLivermore, CSDalack, GWMcFinton, PR. et al. Cocaine, ethanol, and genotype effects on human midbrain serotonin transporter binding sites and mRNA levels. Am J Psychiatry 1998; 155: 207–13.Google ScholarPubMed
Lopez-Ibor, JLana, FSaiz, J.Serotonin, impulsiveness and aggression in humans. Cassano, GBAkiskal, HS, Eds.; Serotonin-related psychiatric syndromes: clinical and therapeutic links. London: Royal Society of Medicine Services; 1991. 35–40.Google Scholar
Makela, P.Alcohol consumption and suicide mortality by age among Finnish men, 1950–1991. Addiction 1996; 91: 101–12.CrossRefGoogle ScholarPubMed
Malcolm, RAnton, RFConrad, SESutherland, S.Carbohydrate-deficient transferrin and alcohol use in medical examiner cases. Alcohol 1999; 17: 7–11.CrossRefGoogle ScholarPubMed
Malison, RTPrice, LHBerman, Rvan Dyck, CHPelton, GHCarpenter, L. et al. Reduced brain serotonin transporter availability in major depression as measured by 〚123I〛-2 beta-carbomethoxy-3 beta-(4-iodophenyl)tropane and single photon emission computed tomography. Biol Psychiatry 1998; 44: 1090–8.CrossRefGoogle Scholar
Mann, JMalone, KPsych, MSweeney, JBrwon, RLinnoila, M. et al. Attempted suicide characteristics and cerebrospinal fluid metabolites in depressed inpatients. Neuropsychopharmacology 1996; 15: 576–86.CrossRefGoogle ScholarPubMed
Mann, JStanley, MMcBride, PMcEwen, B.Increased serotonin2 and beta-adrenergic binding in frontal cortices of suicide victims. Arch Gen Psychiatry 1986; 43: 954–9.CrossRefGoogle ScholarPubMed
Marazziti, DRotondo, APresta, SPancioli-Guadagnucci, MPalego, LConti, L.Role of serotonin in human aggressive behaviour. Aggressive Behav 1993; 19: 347–53.3.0.CO;2-C>CrossRefGoogle Scholar
Meltzer, HLowy, M.The serotonin hypothesis of depression. Meltzer, H, Ed.; Psychopharmacology, the third generation of progress. New York: Raven Press; 1987.Google Scholar
Modai, IApter, AMeltzer, MTyano, SWalevski, AJerushalmy, Z.Serotonin uptake by platelets of suicidal and aggressive adolescent psychiatric inpatients. Neuropsychobiology 1989; 21: 9–13.CrossRefGoogle ScholarPubMed
Moffitt, TEBrammer, GLCaspi, AFawcett, JPRaleigh, MYuwiler, A. et al. Whole blood serotonin relates to violence in an epidemiological study. Biol Psychiatry 1998; 43: 446–57.CrossRefGoogle Scholar
Moss, HB.Serotonergic activity and disinhibitory psychopathy in alcoholism. Med Hypotheses 1987; 23: 353–61.CrossRefGoogle ScholarPubMed
Murphy, GArmstrong, JHermele, SFischer, JClendenin, W.Suicide and alcoholism: interpersonal loss confirmed as a predictor. Arch Gen Psychiatry 1979; 36: 65–9.CrossRefGoogle ScholarPubMed
Murphy, GWetzel, R.The lifetime risk of suicide in alcoholism. Arch Gen Psychiatry 1990; 47: 383–92.CrossRefGoogle ScholarPubMed
Nassberger, LTraskman-Bendz, L.Increased soluble interleukin-2 receptor concentrations in suicide attempters. Acta Psychiatr Scand 1993; 88: 48–52.CrossRefGoogle ScholarPubMed
Neaton, JDBlackburn, HJacobs, DKuller, LLee, DJSherwin, R. et al. Serum cholesterol level and mortality findings for men screened in the Multiple Risk Factor Intervention Trial. Multiple Risk Factor Intervention Trial Research Group. Arch Intern M 1992; 152: 1490–1500.CrossRefGoogle ScholarPubMed
Nicholls, PEdwards, GKyle, E.Alcoholics admitted to four hospitals in England: general and cause-specific mortality. Q J Stud Alcohol 1974; 35: 841–55.CrossRefGoogle ScholarPubMed
Nielsen, DAVirkkunen, MLappalainen, JEggert, MBrown, GLLong, JC. et al. A tryptophan hydroxylase gene marker for suicidality and alcoholism. Arch Gen Psychiatry 1998; 55: 593–602.CrossRefGoogle ScholarPubMed
Norstrom, T.Alcohol and suicide: a comparative analysis of France and Sweden. Addiction 1995; 90: 1463–9.CrossRefGoogle ScholarPubMed
Oxenstierna, GEdman, GIselius, LOreland, LRoss, SSedvall, G.Concentrations of monoamine metabolism in the cerebrospinal fluid of twins and unrelated individuals: a genetic study. J Psychiatr Res 1986; 20: 19–29.CrossRefGoogle ScholarPubMed
Pihl, RYpung, SHarden, PPlotnick, SChamberlain, BErvin, F.Acute effect of altered tryptophan levels and alcohol on aggression in normal human males. Psychopharmacology 1995; 119: 353–360.CrossRefGoogle ScholarPubMed
Preuss, UKoller, GSoyka, MBondy, B.Association between suicide attempts and 5-HTTLPR-S-allele in alcohol dependent subjects and controls: further evidence from a German alcohol dependent inpatient sample. Biol Psychiatry in pressGoogle Scholar
Robins, E.The final months: a study of the lives of 134 persons who committed suicide. New York: Oxford Univ Press; 1981.Google Scholar
Rommelspacher, HMay, TDufeu, PSchmidt, LG.Longitudinal observations of monoamine oxidase B in alcoholics: differentiation of marker characteristics. Alcohol Clin Exp Res 1994; 18: 1322–9.CrossRefGoogle ScholarPubMed
Rossow, IAmundsen, A.Alcohol abuse and suicide: a 40-year prospective study of Norwegian conscripts. Addiction 1995; 90: 685–91.CrossRefGoogle ScholarPubMed
Roy, A.Relation of family history of suicide to suicide attempts in alcoholics. Am J Psychiatry 2000; 157: 2050–1.CrossRefGoogle ScholarPubMed
Salomon, RMazure, CDelgado, PMendia, PCharney, D.Serotonin function in aggression: the effects of acute plasma tryptophan depletion in aggressive patients. Biol Psychiatry 1994; 35: 570–2.CrossRefGoogle Scholar
Samochowiec, JLesch, KPRottmann, MSmolka, MSyagailo, YVOkladnova, O. et al. Association of a regulatory polymorphism in the promoter region of the monoamine oxidase A gene with antisocial alcoholism. Psychiatry Res 1999; 86: 67–72.CrossRefGoogle ScholarPubMed
Saudou, FAmara, DDierich, ALemeur, MRamboz, SSegu, L. et al. Enhanced aggressive behavior in mice lacking 5-HT1B receptor. Science 1994; 265: 1875–8.CrossRefGoogle ScholarPubMed
Schuckit, MMazzanti, CSmith, TAhmed, URadel, MIwata, N. et al. Selective genotyping for the role of 5-HT2A, 5-HT2C, and GABA?6 receptors and the serotonin transporter in the level of response to alcohol: a pilot study. Biol Psychiatry 1999; 45: 647–51.CrossRefGoogle ScholarPubMed
Schuckit, MSmith, T.An 8-year follow-up of 450 sons of alcoholics and control subjects. Arch Gen Psychiatry 1996; 53: 202–210.CrossRefGoogle Scholar
Skog, OTeixera, ZBarrias, JMoreira, R.Alcohol and suicide-the Portuguese experience. Addiction 1995; 90: 1053–61.CrossRefGoogle ScholarPubMed
Skog, O.Alcohol and suicide in Denmark 1911-24-experiences from a ‘natural experiment'. Addiction 1993; 88: 1189–93.CrossRefGoogle ScholarPubMed
Soubrié, P.Reconciling the role of central serotonin neurons in human and animal behavior. Behav Brain Res 1987; 9: 319–364.Google Scholar
Takahashi, SYamane, HKondo, HTani, NKato, N.CSF monoamine metabolites in alcoholism: a comparative study with depression. Folia Psychiatr Neurol Jpn 1974; 28: 347–54.Google ScholarPubMed
Traskman, LAsberg, MBertilsson, L.Monoamine metabolites in CSF and suicidal behaviour. Arch Gen Psychiatry 1981; 38: 631–6.CrossRefGoogle Scholar
Traskman-Bendz, LAlling, COreland, LRegnell, GVinge, EOhman, R.Prediction of suicidal behavior from biologic tests. J Clin Psychopharmacol 1992; 12: 21S–26S.Google ScholarPubMed
Türker, TSodmann, RGoebel, UJatzke, SKnapp, MLesch, K. et al. High ethanol tolerance in young adults is associated with the low-activity variant of the promoter of the human serotonin transporter gene. Neurosci Lett 1998; 248: 147–50.CrossRefGoogle ScholarPubMed
Van Praag, H.Significance of biochemical parameters in the diagnosis, treatment and prevention of depressive disorders. Biol Psychiatry 1977; 12: 101–31.Google Scholar
Virkunnen, MKallio, ERawlings, RTokola, RPoland, RGuidotti, A. et al. Personality profiles and state aggressiveness in Finnish alcoholic, violent offenders, fire setters, and healthy volunteers. Arch Gen Psychiatry 1994; 51: 28–33.CrossRefGoogle Scholar
Vollrath, MAlnaes, RTorgersen, S.Differential effects of coping in mental disorders: a prospective study in psychiatric outpatients. J Clin Psychol 1996; 52: 125–35.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
Walsh, MPHoworth, PJMarks, V.Pyridoxine deficiency and tryptophan metabolism in chronic alcoholics. Am J Clin Nutr 1966; 19: 379–83.CrossRefGoogle ScholarPubMed
Whitfield, JBPang, DBucholz, KKMadden, PAHeath, ACStatham, DJ. et al. Monoamine oxidase: associations with alcohol dependence, smoking and other measures of psychopathology. Psychol M 2000; 30: 443–54.CrossRefGoogle ScholarPubMed
Whitters, ACadoret, RWidmir, R.Factors associated with suicide attempts in alcohol abusers?. J Affective Disord 1985; 9: 19–23.CrossRefGoogle ScholarPubMed
Zureik, MDucimetiere, P.High alcohol-related premature mortality in France: concordant estimates from a prospective cohort study and national mortality statistics. Alcohol Clin Exp Res 1996; 20: 428–433.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.