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Comparison of lithium levels between suicide and non-suicide fatalities: cross-sectional study

Published online by Cambridge University Press:  27 August 2024

S. Ando ,
H. Suzuki ,
T. Matsukawa ,
S. Usami ,
H. Muramatsu ,
K. Yokoyama ,
Y. Okazaki  and
A. Nishida
S. Ando*
Affiliation:
1The University of Tokyo, Tokyo
H. Suzuki
Affiliation:
2Jichi Medical University, Tochigi
T. Matsukawa
Affiliation:
3Juntendo University
S. Usami
Affiliation:
1The University of Tokyo, Tokyo
H. Muramatsu
Affiliation:
4Tokyo Medical Examiner’s Office, Tokyo
K. Yokoyama
Affiliation:
3Juntendo University
Y. Okazaki
Affiliation:
5Michinoo Hospital, Nagasaki
A. Nishida
Affiliation:
6Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
*
*Corresponding author.

Abstract

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Introduction

Ecological studies have suggested the protective effect of micro-dose lithium in drinking water against suicide, however, the association between body lithium level and suicide is unknown.

Objectives

We aimed to compare body lithium levels between suicide and non-suicide fatalities.

Methods

This cross-sectional study included 12 suicides and 16 non-suicides who were examined or dissected at the Tokyo Medical Examiner’s Office from March 2018 to June 2021. The aqueous humor lithium concentration was measured twice using inductively coupled plasma mass spectrometry. Analysis of covariance (ANCOVA) was used to compare the lithium concentration between suicides and non-suicides. Mixed-effects model was conducted to account for all lithium concentration data.

Results

The aqueous humor lithium concentration did not change after death (t(7)=-0.70, SE=0.03, 95% CI=[-0.09, 0.05], P=0.51, Cohen’s d=0.01). The aqueous humor lithium concentration was lower in suicides (mean 0.50 μg/L (variance s2 0.04)) than in non-suicides (mean 0.92 μg/L (s2 0.07)) (t(26)=4.47, SE=0.09, 95% CI=[0.22 to 0.61], P<0.001, Cohen’s d=1.71). The ANCOVA showed that death by suicide was significantly associated with lower lithium concentration (F(1, 24)=8.57, P=0.007), and the effect size was large (ηp2=0.26). The random intercept model showed a significant effect of suicide on aqueous humor lithium concentration (b=-0.261, SE=0.102, 95% CI=[-0.471 to -0.051], t(24)=-2.568, P=0.017).

Conclusions

The results of this study demonstrate that even micro-dose lithium is associated with suicide death. Clinical studies are warranted to examine the effects of micro-dose lithium on suicide prevention.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S351
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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