Correspondence| Volume 52, ISSUE 4, P375-376, August 15, 2002

Low CSF 5-HIAA level in high-lethality suicide attempters: fact or artifact?

      We read with interest the article by
      • Placidi G.P.A.
      • Oquendo M.A.
      • Malone K.M.
      • Huang Y.-Y.
      • Ellis S.P.
      • Mann J.J.
      Aggressivity, suicide attempts, and depression Relationship to cerebrospinal fluid monoamine metabolite levels.
      on the relationship of monoamine metabolites in cerebrospinal fluid (CSF) to aggressivity, suicidal behavior, and depression. The findings, however, require some comments.
      • 1.
        Using Student’s t test, the authors found significantly (p = .048) lower mean CSF 5-HIAA in high-lethality suicide attempters (85.5 ± 26.1 n = 20) compared with low-lethality suicide attempters (103.1 ± 39.5 n = 37). In the group of nonattempters (n = 34), the mean 5-HIAA concentration was 98.4 ± 35.2 pmol/mL. The small difference in the mean values between high-lethality attempters and nonattempters (−13.1%) was not reported to be significant. Thus, the small intergroup differences, partially significant by the t test, indicate a large overlapping of individual 5-HIAA values rather than an association of lower 5-HIAA concentration with a history of a higher lethality suicide attempt. The presentation of a 95% confidence interval for the mean values would be informative in this respect.
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