DIMENSIONS OF AFFECT AND SERUM LIPIDS IN DEPRESSED SUICIDE ATTEMPTERS

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DIMENSIONS OF AFFECT AND SERUM LIPIDS IN
DEPRESSED SUICIDE ATTEMPTERS

• Paplos K., Kontaxakis V., Havaki-Kontaxaki B.,
  Ferentinos P., Soldatos C.
• Eginition Hospital, Department of Psychiatry,
  University of Athens

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INTRODUCTION

• Research over the past years made apparent, that
  the suicidal behaviour is the consequence of a
  complex, and dynamic interaction, between
  multi-dimensional risk factors.
• ( Hawton K, van Heeringen K, 2002 )
• In this sense, this study examines the
  relationship between Depression, dimensions of
  the affect ( Impulsivity, Anhedonia, Alexithymia
  ), and Serum Lipid fractions ( HDL-C, LDL-C, TR )
  levels in suicide attempters.

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INTRODUCTION cont.

• Cholesterol has been related to depression,
  impulsivity and suicidal behaviour.
• ( Muldoon 1990, Kaplan 1994 )
• However, the results of studies examining
  cholesterol, depression and psychological
  correlates, have been conflicting.
• Anhedonia, the loss of pleasure and interest,
  is well recognized as occurring during depressive
  illness. A few studies have suggested a
  relationship between anhedonia and suicidal
  behaviour.
• (Fawcett 1990, Nordström 1995, Loas 2000 )
• Alexithymia, no words for mood, are often
  associated with depression, but little is known
  about the associations between alexithymia and
  suicidal behaviour.
• (Taiminen 1996, Hintikka 2004)

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METHOD

• SETTING General Hospital, Athens, Greece.
• SUICIDE ATTEMPT DEFINITION as developed for the
  WHO in European Study on Parasuicide (Platt et al
  1992).
• SUBJECTS 50 depressed (current depressive
  episode) patients, admitted to Pathology
  Department following suicide attempt by overdose.
• EXCLUSION CRITERIA
• - Age lt18 or gt65 years
• - Significant weight loss in the month prior
  to admission
• - Current infection
• - Abnormality on haematological, liver, renal
  function tests
• - Patients who used lipid-lowering drugs
• - Eating disorders, Psychotic disorders, and
  Substances-
• Related disorders
  

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METHOD cont.

• ASSESSMENTS
• - Clinical evaluation was performed by two
  independent
• psychiatrists.
• - Patients were diagnosed according to
  DSM-IV criteria.
• Rating Scales
• - Depression severity Montgomery-Asberg
  Depression Rating Scale
• ( MADRS Montgomery et al 1979, Snaith et al
  1986, Müller et al 2003, 10-item scale, rated
  0-6, total score 60, gt20 moderate, gt31 severe)
• - Anhedonia MADRS item 8 ( inability to feel,
  MADRS-8 )
• - Impulsivity Impulsivity Rating Scale
• ( IRS Lecrubier et al1995, 7-item scale,
  rated 0-3, total score 21, gt8 impulsive)
  
• - Alexithymia Schalling-Sifneos Personality
  Scale-Revised
• ( SSPS-R Sifneos 1986, 20 true / false items,
  gt10 alexithymia )

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METHOD cont.

• Blood samples were collected by a trained doctor
  within 24h of admission (following overnight
  fast).
• Serum lipid concentrations were assessed using
  enzymatic methods.
• All patients gave written consent.
• Data were analyzed using the SPSS software
  (version 8.0) for windows.
• Pearson correlations were used.

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RESULTS

• Gender 68 F
• VARIABLE MEAN
  SD
• Age (years ) 35.0
  12.2
• MADRS 33.5
  5.9
• MADRS-8 4.3
  0.9
• IRS 9.3
  3.9
• SSPS-R 10.3
  3.7
• TSC (mg/dl) 175.1
  29.5
• HDL-C 47.0
  13.1
• LDL-C 109.5
  23.5
• STR 89.4
  39.0

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RESULTS cont.
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COMMENTS

• To the best of our knowledge this is the first
  study to assess correlation between serum lipid
  profiles, anhedonia, and alexithymia in depressed
  suicide attempters.
• The sample size is small.
• There is not control group.
• A single measurement of serum cholesterol made at
  admission.
• Further studies are needed to clarify, the trait
  or state dependent character of biological
  factors ( cholesterol ) and psychological
  correlates ( impulsivity, anhedonia, alexithymia
  ), and their interactions.
• The study is undergoing, did includes a control
  group ( depressed patients who have never made a
  suicide attempt ), and aims to study the
  relatioship between biological, psychological and
  social factors.