Analysis of 65 studies reveals low cholesterol levels are significantly associated with increased suicide risk

This study was published in the Journal of Psychiatry and Neuroscience 2016 Jan;41(1):56-69

Study title and authors:
Serum lipid levels and suicidality: a meta-analysis of 65 epidemiological studies.

Wu S, Ding Y, Wu F, Xie G, Hou J, Mao P.
Research Center for Clinical Medicine, the 302nd Hospital of PLA, Beijing, China

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/26505144

This study was a systematic review of the scientific literature and meta-analysis to determine the association between cholesterol levels and suicide. The analysis included 65 studies with a total of 510,392 participants. The participants were categorized as follows:
(i) patients with various psychiatric diseases (e.g., depression, schizophrenia, personality disorder, drug and alcohol addictions) with suicidality, who were defined as suicidal patients;
(ii) patients with various psychiatric diseases without suicidality, who were defined as nonsuicidal patients;
(iii) healthy participants without any psychiatric disease and suicidality, who were defined as healthy controls.

The study found:
(a) Compared with the nonsuicidal patients, suicidal patients had significantly lower cholesterol levels, LDL cholesterol levels and triglyceride levels.  
(b) Compared with the healthy controls, suicidal patients had significantly lower cholesterol levels, HDL cholesterol levels and LDL cholesterol levels.
(c) Compared with those with the highest cholesterol levels, participants with lower cholesterol levels had a 112% higher risk of suicidality, including a 123% higher risk of suicide attempt and an 85% higher risk of suicide completion.

Links to other studies:
Suicide attempters have low cholesterol levels
Low cholesterol is associated with major depressive disorder and death from suicide
Low cholesterol is significantly associated with schizophrenia

The association between suicidal behavior and low levels of cholesterol in people with schizophrenia.

This study was published in Medical Science Monitor 2014 Aug 21;20:1486-90

 

Study title and authors:

Suicidal behavior in schizophrenia may be related to low lipid levels.

Ainiyet B, Rybakowski JK

Department of Psychiatry, Akerhus Universytetssykehus, Oslo, Norway.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25141886

The aim of the study was to investigate the correlation between suicidal behaviour and cholesterol levels in schizophrenia patients admitted to a psychiatric hospital during the three months prior to their admission. The study included 148 (69 males, 79 females) schizophrenia patients with an average age of 32 years, all recently admitted to psychiatric hospital due to acute exacerbation of their mental illness. 

The study found:
(a) Schizophrenic men with suicidal thoughts had 21% lower cholesterol levels than schizophrenic men without suicidal thoughts.
(b) Schizophrenic men who attempted suicide had 27% lower cholesterol levels than schizophrenic men without suicidal thoughts.
(c) Schizophrenic women with suicidal thoughts had 26% lower cholesterol levels than schizophrenic women without suicidal thoughts.
(d) Schizophrenic women who attempted suicide had 31% lower cholesterol levels than schizophrenic women without suicidal thoughts.
(e) Schizophrenic men with suicidal thoughts had 21% lower levels of low density lipoprotein (LDL) cholesterol than schizophrenic men without suicidal thoughts.
(f) Schizophrenic men who attempted suicide had 36% lower levels of low density lipoprotein (LDL)cholesterol than schizophrenic men without suicidal thoughts.
(g) Schizophrenic women with suicidal thoughts had 30% lower levels of low density lipoprotein (LDL) cholesterol than schizophrenic women without suicidal thoughts.
(h) Schizophrenic women who attempted suicide had 35% lower levels of low density lipoprotein (LDL) cholesterol than schizophrenic women without suicidal thoughts.
(i) Schizophrenic men with suicidal thoughts had 37% lower triglyceride levels than schizophrenic men without suicidal thoughts.
(j) Schizophrenic men who attempted suicide had 56% lower triglyceride levels than schizophrenic men without suicidal thoughts.
(k) Schizophrenic women with suicidal thoughts had 40% lower triglyceride levels than schizophrenic women without suicidal thoughts.
(l) Schizophrenic women who attempted suicide had 41% lower triglyceride levels than schizophrenic women without suicidal thoughts.

Ainiyet concluded: "The results of our study add to a growing body of evidence showing the association between suicidal behavior and low levels of total cholesterol in people with schizophrenia. In addition, we found that this association may also apply to low total lipids, and, in most cases, to low LDL cholesterol and triglycerides".

Suicide associated with low cholesterol

This study was published in the Journal of Affective Disorders 2004 Aug;81(2):161-6

 

Study title and authors:

Clinical application of low serum cholesterol as an indicator for suicide risk in major depression.

Kim YK, Myint AM

Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea. yongku@korea.ac.kr

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/15306143

This study explored the relationship between cholesterol levels and suicide risk in patients with depression. The study included 149 major depressive disorder patients admitted to an emergency room following a suicide attempt, 149 non-suicidal depressive controls, and 251 normal controls.

The study found:
(a) Depressed suicidal patients had 21% lower cholesterol levels than the normal subjects.
(b) Depressed non-suicidal patients had 5% lower cholesterol levels than the normal subjects.
(c) In suicide patients, cholesterol levels were 12% lower in violent suicide patients than non-violent suicide patients.

This study suggests that low cholesterol levels are associated with an increased risk of suicide.

The adverse health effects of low cholesterol

This paper was published in Beijing Da Xue Xue Bao (Journal of Peking University) 2010 Oct 18;42(5):612-5

Study title and authors:
Primary and secondary hypocholesterolemia

Song JX, Ren JY, Chen H.
Department of Cardiology, Peking University People's Hospital, Beijing 100044, China.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/20957025

In this review of the literature Song examines the influence of low cholesterol levels (hypocholesterolemia) on health.

He found:
(a) Low cholesterol levels are common in the population.
(b) Physicians pay little attention to the diseases, causes and consequences of low cholesterol in clinical practice.
(c) Low cholesterol levels can result in some adverse events, such as increased death rates, intracerebral hemorrhage, cancer, infection, adrenal failure, suicide and mental disorder.
(d) Despite the adverse health consequences of low cholesterol, physicians are increasingly prescribing cholesterol lowering treatments such as statin drugs.

With all the adverse health effects of low cholesterol Song concludes: "It's high time that physicians attached more importance to hypocholesterolemia."

Links to other studies:
Stroke patients with low cholesterol are more likely to die and have poor neurological outcomes
Low cholesterol levels lead to a 20.2% increase in death rates in those who have had a stroke
Low cholesterol and serious complications after an ischemic stroke

Low cholesterol levels associated with fatigue and depression

This study was published in the Journal of Psychosomatic Research 2002 Feb;52(2):61-3

Study title and authors:

Cholesterol and mood states at 3 days after delivery.

Nasta MT, Grussu P, Quatraro RM, Cerutti R, Grella PV.

Institute of Obstetrics and Gynaecology, University of Padua, Padua, Italy.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/11832250

The aim of the study was to investigate the relationship between cholesterol and mood states in women immediately following childbirth. The study included 72 women who had their mood analysed and cholesterol levels measured three days after giving birth.

The study found that women with lower cholesterol levels immediately following childbirth had major feelings of fatigue and a depressed mood.

Low cholesterol is significantly associated with schizophrenia

This study was published in Acta Psychiatrica Scandinavica 2003 Sep;108(3):208-14

Study title and authors:

Serum leptin and cholesterol levels in schizophrenic patients with and without suicide attempts.

Atmaca M, Kuloglu M, Tezcan E, Ustundag B.

Departments of Psychiatry and Clinical Biochemistry, Firat University, School of Medicine, Elazig, Turkey. matmaca_p@yahoo.com

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12890276

The study examined the association of cholesterol levels in schizophrenic patients with and without suicide attempts. The study included 16 medication-free schizophrenic patients with and without suicide attempts and in 16 healthy controls.

The study found:
(a) The schizophrenic patients had lower cholesterol levels compared with the controls.
(b) The schizophrenic patients who had attempted suicide had significantly lower cholesterol levels compared with the schizophrenic patients who had not.
(c) Cholesterol levels were lower in violent suicide attempters when compared with non-violent suicide attempters.

The results of the study show that low cholesterol is significantly associated with schizophrenia, especially in suicide attempters and even more so in violent suicide attempters.

Low cholesterol linked to an increased risk of suicide

This study was published in Psychiatry Research 2011 Jun 30;188(1):83-7

 

Study title and author:

Low cholesterol is a risk factor for attentional impulsivity in patients with mood symptoms.

Troisi A.

Department of Neurosciences, University of Rome Tor Vergatta, Rome, Italy. alfonso.troisi@uniroma2.it

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/21112642

Troisi notes that attentional impulsivity is a demonstrated risk factor for suicide. Attentional impulsivity is related to mania and depression.

The study examined the relationship between cholesterol levels and attentional impulsivity in 301 patients with mood, anxiety, and personality disorders.

The study found:
(a) Lower cholesterol levels were associated with increased attentional impulsivity.
(b) Participants with cholesterol levels lower than 165mg/dL (4.2 mmol/L) were at a significantly increased risk of attentional impulsivity compared with the rest of the group.

The study shows that low cholesterol is associated with increased attentional impulsivity, and considering that attentional impulsivity is a demonstrated risk factor for suicide, the results of the study suggest that low cholesterol may be linked to an increased risk of suicide.

Links to other studies:
Lowering cholesterol levels lead to an increase in death from accidents, suicide, and violence
Low cholesterol levels associated with violence, antisocial behaviour and premature death
Both low cholesterol levels and declining cholesterol levels are associated with increased risk of death from suicide in men

The lower the cholesterol level - the higher the risk of suicide

This study was published in Acta Psychiatrica Scandinavica 2003 Sep;108(3):215-21

Study title and authors:
Serum lipid levels and suicide attempts.

Lee HJ, Kim YK.
Department of Psychiatry, Korea University, College of Medicine, Ansan City, Korea.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12890277

The objective of the study was to determine whether a correlation exists between lower cholesterol levels and increased suicide risk. Cholesterol levels were measured in 60 patients who had recently experienced failed attempts at suicide and equal numbers of non-suicidal patients.

The study found:
(a) Total cholesterol levels were significantly lower in suicide attempt patients compared to non-suicidal patients.
(b) Low density lipoprotein (LDL) cholesterol levels were significantly lower in suicide attempt patients compared to non-suicidal patients.
(c) The lower the cholesterol level - the higher the risk of suicide.

This study shows the lower the cholesterol level - the higher the risk of suicide.

Links to other studies:
Evidence of how low cholesterol leads to suicidal behaviour
Low cholesterol levels are associated with more suicide attempts
Those with the lowest cholesterol levels have more than six times the risk of committing suicide than those with the highest cholesterol levels

Low cholesterol levels are associated with higher rates of attempted suicide

This study was published in the Indian Journal of Psychiatry 1999 Oct;41(4):300-6

Study title and authors:
Serum lipid profile in suicide attempters.

Verma S, Trivedi JK, Singh H, Dalal PK, Asthana OP, Srivastava JS, Mishra R, Ramakant, Sinha PK.
SANDEEP VERMA, Senior resident Doctor, Department of Psychiatry, K.G's Medical College, Lucknow.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/21430801

This study investigated the association of cholesterol levels with suicidal behaviour. Cholesterol profiles of 40 suicide attempters were compared with 40 non suicidal control subjects.

The study found:
(a) Total cholesterol levels were 8.7% lower in suicide attempters compared to non suicidal subjects.
(b) High density lipoprotein (HDL) cholesterol levels were 1.7% lower in suicide attempters compared to non suicidal subjects.
(c) Levels of "the so called bad" low density lipoprotein (LDL) cholesterol were 10.5% lower in suicide attempters compared to non suicidal subjects.

The results of this study show that low cholesterol levels are associated with higher rates of attempted suicide.

Links to other studies:
Low Cholesterol, Depression and Suicide in Women
Lowering cholesterol levels lead to an increase in death from accidents, suicide, and violence
Low cholesterol leads to increased suicide

Both low cholesterol levels and declining cholesterol levels are associated with increased risk of death from suicide in men

This study was published in the British Medical Journal 1996 Sep 14;313(7058):649-51

Study title and authors:
Serum cholesterol concentration and death from suicide in men: Paris prospective study I.

Zureik M, Courbon D, Ducimetière P.
National Institute of Health and Medical Research (INSERM), Unit 258, Hôpital Broussais, Paris, France.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/8811757

The aim of the study was to investigate whether low cholesterol levels or changing cholesterol levels are associated with the risk of suicide in men.

The study contained 6,393 working men, aged 43-52, who had at least three measurements of their cholesterol levels over a 17 year period.

The study found:
(a) Men with low cholesterol (below 4.78 mmol/l (185 mg/dL)) had a 216% increase in suicide compared with men whose cholesterol was between 4.78-6.21 mmol/l (185-240mg/dL).
(b) Men whose cholesterol levels decreased by more than 0.13 mmol/l (5 mg/dL) a year had an 117% increase in suicide compared with men whose cholesterol remained stable.

To conclude: Both low cholesterol levels and declining cholesterol levels were associated with increased risk of death from suicide in men.

High cholesterol levels reduce depression

Published in Biol Psychiatry. 2010 Jul 15;68(2):125-32. Epub 2010 May 26.

Gender and genotype modulation of the association between lipid levels and depressive symptomatology in community-dwelling elderly (the ESPRIT study).
Ancelin ML, Carrière I, Boulenger JP, Malafosse A, Stewart R, Cristol JP, Ritchie K, Chaudieu I, Dupuy AM.
Institut de la Santé et de la Recherche Médicale (Inserm) and University of Montpellier 1, Hopital La Colombiere, Centre Hospitalier Universitaire (CHU), Montpellier, France. marie-laure.ancelin@inserm.fr

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/20537614
 
The study assessed depression in a population of 1040 women and 752 men aged 65 years and older with a 7-year follow-up.
 
It found men with a low low-density lipoprotein (LDL) cholesterol levels had twice the risk of depression, whereas in women low high-density lipoprotein (HDL) cholesterol levels were found to be significantly associated with increased depression.
 
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