Re: Low Cholesterol associated with school suspension or expulsion & marker for aggression
From: Sharon Hope (shope_at_anet.net)
Date: 03/20/05
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Date: Sat, 19 Mar 2005 16:51:15 -0800
Adults, too, have demonstrated that low cholesterol has a positive
correlation with mood and behavior, particularly aggression, violence,
crime, depression, and/or suicide attempts. Actually, more than I had
expected to find:
Low Cholesterol and Aggression, Violence, Crime, Depression, Suicide
Attempts
Several published medical studies have found that low cholesterol levels
have a direct correlation with mood and behavior, particularly aggression,
violence, crime, depression, and/or suicide attempts.
Findings include:
· The authors concluded that, among
non-African-American children, low total cholesterol is associated with
school suspension or expulsion and that low total cholesterol may be a risk
factor for aggression or a risk marker for other biologic variables that
predispose to aggression.
· A significant increase in SERT (Serotonin transporter) activity was
detected only during the first month of simvastatin therapy. This finding
suggests that within this period some patients could be vulnerable to
depression, violence, or suicide.
· This paper reviews early biological risk factors for violence.
These factors include . low cholesterol. A biopsychosocial violence mode is
proposed.
· The results suggest that total cholesterol level may be a useful
biological marker for the risk of suicide in depression patients.
· The results indicated that medication-free schizophrenic patients
have statistically significant lower serum cholesterol and leptin levels
compared with controls and the difference is obvious in suicide attempters
compared with non-suicide attempters and in violent attempters than
non-violent attempters.
· Patients with a violent suicidal attempt have significantly lower
cholesterol levels than patients with non-violent attempts and the control
subjects. Our findings suggest that suicide attempts should not be
considered a homogeneous group. They are consistent with the theory that low
levels of cholesterol are associated with increased tendency for impulsive
behavior and aggression and contribute to a more violent pattern of suicidal
behavior.
· . The TC (low total serum cholesterol) level seems to be a
peripheral marker with prognostic value among boys with conduct disorder and
antisocial male offenders.
· Our results confirm previous reports of lower serum cholesterol in
attempted suicide. They are also indicative of an increased noradrenaline
turnover in subjects who attempt suicide, at least within 24 hours after the
attempt. Whether this activation precedes or follows the attempt because of
the specific stress, can not be answered at present.
· Low cholesterol may effect serotonergic neuronal activity and some
types of 5-HT receptors, then may be related to violent behavior during
sleep.
· These findings are consistent with the cholesterol-serotonin
hypothesis and with the substantive literature linking both aggression and
depression to depressed central serotonergic activity.
· Adjusting for other factors, low cholesterol is associated with
increased subsequent criminal violence.
· These findings suggest the possibility that serum cholesterol
levels may be positively associated with serotonergic receptor function. The
existence of such an association may provide an explanation for reported
increases in depression, suicide and violence in individuals with low or
lowered cholesterol.
· Our results showed that low serum cholesterol level is associated
with the violence of the suicide attempt and not with the suicide attempt
itself. Further investigations are necessary to determine the usefulness of
this easily accessible parameter as a potential risk indicator for violent
acts such as violent suicidal behavior in susceptible individuals.
· Men with a lower cholesterol level (< or =4.5 mmol/liter) have a
higher prevalence of depressive symptoms than those with a cholesterol level
between 6 and 7 mmol/liter. These data may be important in the ongoing
debate on the putative association between low cholesterol levels and
violent death.
Some relatively recent full abstracts:
http://aje.oupjournals.org/cgi/content/abstract/161/7/691
Association of Serum Cholesterol and History of School Suspension among
School-age Children and Adolescents in the United States
Jian Zhang1, Matthew F. Muldoon2, Robert E. McKeown3 and Steven P. Cuffe4
1 Division of Health and Family Studies, Institute for Families in Society,
University of South Carolina, Columbia, SC
2 Center for Clinical Pharmacology, University of Pittsburgh School of
Medicine, Pittsburgh, PA
3 Department of Epidemiology and Biostatistics, Arnold School of Public
Health, University of South Carolina, Columbia, SC
4 Department of Neuropsychiatry and Behavioral Science, Division of Child
and Adolescent Psychiatry, University of South Carolina School of Medicine,
Columbia, SC
Correspondence to Dr. Jian Zhang, 4770 Buford Highway, MS K-24, Atlanta, GA
30341 (e-mail: bvw2@cdc.gov).
The dietary guidelines developed for adults have been extended to children,
but the role of serum cholesterol in the neurodevelopment of children is
poorly understood. In the Third National Health and Nutrition Examination
Survey (1988-1994), serum total cholesterol was measured in 4,852 children
aged 6-16 years. Psychosocial development was evaluated by interviewing the
mother regarding the child's history of school suspension or expulsion and
difficulty in getting along with others. After adjustment for family
socioeconomic status, maternal marital status and education, children's
nutrition, and academic performance, the odds ratios of children with
various concentrations of total cholesterol showed the children to be
equally comfortable in their own peer subculture and not to be different in
the proportion that had seen a mental health professional. However,
non-African-American children with a serum total cholesterol concentration
below the 25th percentile (<145 mg/dl) were almost threefold more likely to
have been suspended or expelled from schools than their peers with total
cholesterol at or above the 25th percentile (odds ratio = 2.96, 95%
confidence interval: 1.55, 5.64). The authors concluded that, among
non-African-American children, low total cholesterol is associated with
school suspension or expulsion and that low total cholesterol may be a risk
factor for aggression or a risk marker for other biologic variables that
predispose to aggression.
--- adolescent psychology; child psychology; cholesterol; juvenile delinquency; United States -------------------------------------------------------------------------------- Abbreviations: CI, confidence interval; DISC, Dietary Intervention Study in Children; NHANES III, Third National Health and Nutrition Examination Survey; STRIP, Special Turku Coronary Risk Factor Intervention Project; WRAT-R, Wide Range Achievement Test, Revised http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15740995 Psychiatry Res. 2005 Feb 28;133(2-3):197-203. Cholesterol-lowering therapy evokes time-limited changes in serotonergic transmission. Vevera J, Fisar Z, Kvasnicka T, Zdenek H, Starkova L, Ceska R, Papezova H. Psychiatric Clinic, First Faculty of Medicine of Charles University, Ke Karlovu 11, 120 00 Prague, Czech Republic; School of Public Health, University of California at Berkeley, Berkeley, CA, USA. A number of studies have reported an increased risk for violent deaths and depression in subjects with reduced serum cholesterol concentrations. Links with hypothesized impairment of serotonin neurotransmission have not been satisfactorily tested. In this investigation, the serum and membrane cholesterol, microviscosity of erythrocyte membranes, platelet serotonin uptake, and clinical parameters were determined during pharmacotherapy of 17 hypercholesterolemic patients. A significant decrease in serum cholesterol and a nonsignificant decrease in membrane cholesterol concentration were found after 2 months of simvastatin therapy. Serotonin transporter (SERT) activity was significantly increased following 1 month of simvastatin; the tendency to decrease the initial increase in SERT activity was evident following 2 months of therapy. Both membrane cholesterol and SERT activity returned to pre-treatment levels after more than 1 year of therapy. Microviscosity of plasma membranes, impulsivity, empathy, adventure, sensation seeking, and depressed mood were not markedly changed. These data indicate that long-term therapy has different effects on serotonin transmission from short-term (1- to 2-month) therapy. A significant increase in SERT activity was detected only during the first month of simvastatin therapy. This finding suggests that within this period some patients could be vulnerable to depression, violence, or suicide. PMID: 15740995 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15680620 Int J Nurs Stud. 2005 Feb;42(2):229-41. Biosocial bases of aggressive and violent behavior--implications for nursing studies. Liu J, Wuerker A. Social Science Research Institute, University of Southern California, Los Angeles, CA 90089-0375, USA. jianghol@usc.edu Although aggression and violence have been increasingly viewed as a major public health problem with a biological and health basis, it has been under-researched in the nursing and health context. This paper reviews early biological risk factors for violence. These factors include pregnancy/birth complications, fetal exposure to nicotine, alcohol, and drugs, low cholesterol, malnutrition, lead and manganese exposure, head injuries and brain dysfunction, low arousal, low serotonin, low cortisol, and high testosterone. A biopsychosocial violence mode is proposed. Finally, the paper argues that nursing is ideally placed to develop a new body of knowledge based on a biosocial perspective that can lead to more effective prevention programs for violence. PMID: 15680620 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15306143 J Affect Disord. 2004 Aug;81(2):161-6. 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 BACKGROUND: Serum total cholesterol is reported to be associated with suicidality and violence. We explored the clinical applicability of low serum total cholesterol as an indicator for suicide risk in major depression. METHOD: We measured the serum cholesterol levels in 149 major depressive disorder patients admitted to an emergency room following a suicide attempt, in 149 non-suicidal depressive controls, and in 251 normal controls. RESULTS: Significant differences in total serum cholesterol levels were observed between the suicide patients and non-suicide depression patients and between violent suicide patients and non-violent suicide patients when age, sex, BMI and total serum protein levels were controlled. The cutoff point of 180 mg/dl gave a high sensitivity (82%), and the cutoff point 150 mg/dl gave a high specificity (72%). These points can be used as discriminative cutoffs between suicidal and non-suicidal depressive patients. LIMITATIONS: A longitudinal study is necessary to confirm the clinical applicability of serum cholesterol as a predictive indicator of suicide risk in depression. CONCLUSION: The results suggest that total cholesterol level may be a useful biological marker for the risk of suicide in depression patients. PMID: 15306143 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12890276 Acta Psychiatr Scand. 2003 Sep;108(3):208-14. 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 OBJECTIVE: Previous studies demonstrate a relationship between lipid metabolism and suicide or impulsive-aggressive behaviours. Leptin seems to be related with lipid metabolism. Therefore, the aim was to measure total serum cholesterol and leptin levels in 16 medication-free schizophrenic patients with and without suicide attempts and in 16 healthy controls. METHOD: Subjects were assessed by using Impulsivity Rating (IRS) and Modified Overt Aggression Scale (MOAS). RESULTS: The patients had lower total cholesterol and leptin levels in serum compared with the controls. Significantly lower total cholesterol and leptin levels were observed in patients who had attempted suicide compared with those who had not. The levels were observed to be low in violent attempters when compared with non-violent attempters. MOAS and IRS scores were negatively correlated with both cholesterol or leptin levels in patients. CONCLUSION: The results indicated that medication-free schizophrenic patients have statistically significant lower serum cholesterol and leptin levels compared with controls and the difference is obvious in suicide attempters compared with non-suicide attempters and in violent attempters than non-violent attempters. PMID: 12890276 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12880147 Clin Chem Lab Med. 2003 Jun;41(6):821-4. Association between increased serum cholesterol and signs of depressive mood. Ledochowski M, Murr C, Sperner-Unterweger B, Neurauter G, Fuchs D. Department of Internal Medicine, Leopold-Franzens University, Innsbruck, Austria. Hypercholesterolemia is associated with an increased risk of atherosclerosis and coronary heart disease. Therefore, therapeutic lowering of cholesterol is an important preventive measure of cardiac morbidity and death. As one side effect, cholesterol-lowering drugs appear to increase the mortality due to suicides or violence, and low lipid concentrations were found to be associated with trait measures of depression. We compared serum cholesterol concentrations and the Beck Depression Rating Scale (Beck's score) in 604 otherwise healthy outpatients who visited the physician's office for a medical health check-up; 65.4% of individuals presented with serum cholesterol concentrations > or = 5.2 mmol/l (> 200 mg/dl) and 5.3% had elevated Beck's score (> 19), indicative for depression. Beck's score was higher in patients with cholesterol concentrations above the 75th percentile (= 6.2 mmol/l; U = 31221, p < 0.02, Mann-Whitney U-test), and Beck's score correlated with cholesterol concentrations and with age. Thus, in contrast to the widely accepted view, in our study, higher cholesterol concentrations were associated with signs of depressive mood. Hypercholesterolemia may not necessarily increase the risk of depressive mood, conversely, increased intake of fat and carbohydrates by individuals with depressive mood may increase cholesterol levels. PMID: 12880147 [PubMed - indexed for MEDLINE] (SH: So, perhaps eating chocolate or other fats and carbohydrates is a natural way to recover from depression?) http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12648892 Eur Psychiatry. 2003 Feb;18(1):23-7. Cholesterol concentrations in violent and non-violent women suicide attempters. Vevera J, Zukov I, Morcinek T, Papezova H. Psychiatric Clinic, 1st Medical Faculty, Charles University of Prague, Prague, Czech Republic. j_vevera@hotmail.com The aim of this study was to evaluate whether women with a history of violent suicide attempts have lower serum cholesterol concentrations than those who attempted suicide by non-violent methods. Our retrospective study used a case-control design to compare serum total cholesterol concentration, hematocrit, red blood cell count and body mass index (BMI) in women with a history of violent (n = 19) or non-violent (n = 51) suicide attempts and of non-suicidal controls (n = 70) matched by diagnosis and age. Analysis of covariance (ANCOVA) with age as the covariate was used to analyze differences in cholesterol levels in groups according to violence. Violence was found to be a significant factor (P = 0.016). Using the Scheffe test, a significant difference (P = 0.011) was revealed between the group of violent and non-violent suicide attempters and between the violent suicide attempters and the control group. Patients with a violent suicidal attempt have significantly lower cholesterol levels than patients with non-violent attempts and the control subjects. Our findings suggest that suicide attempts should not be considered a homogeneous group. They are consistent with the theory that low levels of cholesterol are associated with increased tendency for impulsive behavior and aggression and contribute to a more violent pattern of suicidal behavior. PMID: 12648892 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12056583 Eur Arch Psychiatry Clin Neurosci. 2002 Feb;252(1):8-11. Total serum cholesterol level, violent criminal offences, suicidal behavior, mortality and the appearance of conduct disorder in Finnish male criminal offenders with antisocial personality disorder. Repo-Tiihonen E, Halonen P, Tiihonen J, Virkkunen M. Department of Forensic Psychiatry, University of Kuopio, Niuvanniemi Hospital, Finland. eila.tiihonen@niuva.fi Associations between low total serum cholesterol (TC) levels and antisocial personality disorder (ASPD), violent and suicidal behavior have been found. We investigated the associations between TC levels, violent and suicidal behavior, age of onset of the conduct disorder (CD) and the age of death among 250 Finnish male criminal offenders with ASPD. The CD had begun before the age of 10 two times more often in non-violent criminal offenders who had lower than median TC levels. The violent criminal offenders having lower than median TC levels were seven times more likely to die before the median age of death in the study material. The violent offenders having lower than median TC levels were eight times more likely to die of unnatural causes. The mean TC level of these male offenders with ASPD was lower than that of the general Finnish male population. Low TC levels are associated with childhood onset type of the CD, and premature and unnatural mortality among male offenders with ASPD. The TC level seems to be a peripheral marker with prognostic value among boys with conduct disorder and antisocial male offenders. PMID: 12056583 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12056581 Eur Arch Psychiatry Clin Neurosci. 2002 Feb;252(1):38-43. Biogenic amine turnover and serum cholesterol in suicide attempt. Tripodianakis J, Markianos M, Sarantidis D, Agouridaki M. Evangelismos General Hospital, Psychiatric Department, Athens, Greece. tripodianakis@hotmail.com The investigation of biological correlates of suicidal behavior is important in searching for possible changes in neuronal systems activity related to that behavior, so that pharmacological interventions may be proposed, especially in high-risk subjects. In a sample of 111 subjects admitted in a general hospital after suicide attempt, we studied the turnover of neurotransmitters by measuring the urinary output of the main metabolites of serotonin, dopamine and noradrenaline (5-HIAA, HVA, MHPG respectively), as well as serum cholesterol, and compared them to those of a group of 62 healthy controls. Venous blood samples and urine samples were collected within 24 hours of admission. Psychiatric diagnosis was made according to DSM-IIIR criteria and assessment of suicide intent with Beck's Suicidal Intent Scale (SIS). Fifty-four (54) subjects received the diagnosis of adjustment disorder, 25 of depression, 16 of schizophrenia and 16 of personality disorder. Fourteen subjects (14) had employed a violent mode of attempt. Urinary MHPG was found significantly higher in all diagnostic groups compared to controls. No difference was found concerning the excretion of HVA and 5-HIAA. Serum total cholesterol was found significantly lower both in violent and non-violent attempters compared to controls after correcting for age. No difference in serum cholesterol or MHPG was found between violent and non-violent attempts. Serum cholesterol and MHPG correlated negatively, while the correlations between cholesterol and 5-HIAA or HVA were not significant. Our results confirm previous reports of lower serum cholesterol in attempted suicide. They are also indicative of an increased noradrenaline turnover in subjects who attempt suicide, at least within 24 hours after the attempt. Whether this activation precedes or follows the attempt because of the specific stress, can not be answered at present. PMID: 12056581 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11952924 Psychiatry Clin Neurosci. 2002 Apr;56(2):195-8. Sleep-related violence and low serum cholesterol: a preliminary study. Agargun MY, Sekeroglu MR, Kara H, Ozer OA, Tombul T, Kiran U, Selvi Y. Department of Psychiatry, Yuzuncu Yil University School of Medicine, Van, Turkey. mehmetyucel@turk.net To examine whether there is a relationship between serum cholesterol level and sleep-related violence, we evaluated 15 patients with violent behavior during sleep (VBS) and 15 normal control subjects. The patient and control groups were matched for sex, age, and weight. There were 13 women and two men in each group. The patients with VBS had lower serum total cholesterol, triglyceride, and low-density lipoprotein levels than the healthy subjects. Low cholesterol may effect serotonergic neuronal activity and some types of 5-HT receptors, then may be related to violent behavior during sleep. PMID: 11952924 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11199085 J Behav Med. 2000 Dec;23(6):519-29. Serum cholesterol concentrations and mood states in violent psychiatric patients: an experience sampling study. Hillbrand M, Waite BM, Miller DS, Spitz RT, Lingswiler VM. Connecticut Valley Hospital, Whiting Forensic Division, P.O. Box 70, Middletown, Connecticut 06457, USA. hillbrandm@ccsu.edu The well-documented negative association between serum cholesterol and aggressive behavior has led Kaplan to propose a cholesterol-serotonin hypothesis of aggression. According to this hypothesis, low dietary cholesterol intake leads to depressed central serotonergic activity, which itself has been reported in numerous studies of violent individuals. In the present study, 25 violent psychiatric patients participated in a microbehavioral experience sampling procedure to examine differences in self-reports of affective and cognitive experiences as a function of serum cholesterol concentrations. For 7 days, they wore signaling devices that emitted an average of seven signals a day. Following each signal, patients filled out a mood questionnaire. Total serum cholesterol (TSC) concentration was positively associated with measures of affect, cognitive efficiency, activation, and sociability, suggesting a link between low TSC and dysphoria. These findings are consistent with the cholesterol-serotonin hypothesis and with the substantive literature linking both aggression and depression to depressed central serotonergic activity. PMID: 11199085 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11104842 J Psychiatr Res. 2000 Jul-Oct;34(4-5):301-9. Low cholesterol and violent crime. Golomb BA, Stattin H, Mednick S. Department of Medicine, University of California, Los Angeles, CA 92093-0995, USA. bgolomb@ucsd.edu BACKGROUND: Community cohort studies and meta-analyses of randomized trials have shown a relation between low or lowered cholesterol and death by violence (homicide, suicide, accident); in primates, cholesterol reduction has been linked to increased behavioral acts of aggression (Kaplan J, Manuck S. The effects of fat and cholesterol on aggressive behaviour in monkeys. Psychosom. Med 1990;52:226-7; Kaplan J, Shively C, Fontenot D, Morgan T, Howell S, Manuck S et al. Demonstration of an association among dietary cholesterol, central serotonergic activity, and social behaviour in monkeys. Psychosom. Med 1994;56:479-84.). In this study we test for the first time whether cholesterol level is related to commission of violent crimes against others in a large community cohort. METHODS: We merged one-time cholesterol measurements on 79,777 subjects enrolled in a health screening project in Varmland, Sweden with subsequent police records for arrests for violent crimes in men and women aged 24-70 at enrollment; and with information on covariates. We performed a nested case control comparison of cholesterol in violent criminals - defined as those with two or more crimes of violence against others - to cholesterol in nonoffenders matched on age, enrollment year, sex, education and alcohol, using variable-ratio matching, with a nonparametric sign test. RESULTS: One hundred individuals met criteria for criminal violence. Low cholesterol (below the median) was strongly associated with criminal violence in unadjusted analysis (Men: risk ratio 1.94, P=0.002; all subjects risk ratio 2.32, P<0.001). Age emerged as a strong confounder. Adjusting for covariates using a matching procedure, violent criminals had significantly lower cholesterol than others identical in age, sex, alcohol indices and education, using a nonparametric sign test (P=0.012 all subjects; P=0.035 men). CONCLUSIONS: Adjusting for other factors, low cholesterol is associated with increased subsequent criminal violence. PMID: 11104842 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11063789 Psychiatry Res. 2000 Oct 30;96(2):167-73. Relationship between serum cholesterol levels and meta-chlorophenylpiperazine-induced cortisol responses in healthy men and women. Terao T, Nakamura J, Yoshimura R, Ohmori O, Takahashi N, Kojima H, Soeda S, Shinkai T, Nakano H, Okuno T. Department of Psychiatry, University of Occupational and Environmental Health, School of Medicine, Yahatanishi-ku, 807-8555, Kitakyushu, Japan. t-terao@med.uoeh-u.ac.jp We investigated the effect of cholesterol on serotonergic receptor function in 20 healthy male and 10 healthy female subjects using cortisol responses to meta-chlorophenylpiperazine (m-CPP) neuroendocrine challenge tests. M-CPP, a metabolite of the antidepressant trazodone, has been widely used in psychopharmacology research as a probe of serotonin function. In the human brain, m-CPP binds both to various serotonergic receptors, mainly 5-HT(2C), and to alpha(2)-adrenoceptors. After an overnight fast, the subjects received m-CPP (0.5 mg/kg) or identical placebo capsules orally in a randomized, double blind, crossover design. Blood was obtained for measurement of cholesterol and cortisol. In some analyses, especially in males, there were significant positive correlations between serum cholesterol levels and cortisol responses. These findings suggest the possibility that serum cholesterol levels may be positively associated with serotonergic receptor function. The existence of such an association may provide an explanation for reported increases in depression, suicide and violence in individuals with low or lowered cholesterol. Publication Types: · Clinical Trial · Randomized Controlled Trial PMID: 11063789 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10963796 Psychiatry Res. 2000 Aug 21;95(2):103-8. Low serum cholesterol in violent but not in non-violent suicide attempters. Alvarez JC, Cremniter D, Gluck N, Quintin P, Leboyer M, Berlin I, Therond P, Spreux-Varoquaux O. Faculte de Medecine Paris-Ouest et Laboratoire de Biochimie, Hopital R. Poincare, AP-HP, 104 Bvd R. Poincare, 92380 Garches, France. jean-claude.alvarez@rcp.ap-hop-paris.fr Many previous studies have suggested that low or lowered serum cholesterol levels may increase the risk of mortality not due to somatic disease: principally, suicide and violent death. Because violent death is rare, some studies have investigated afterwards the relation between cholesterol levels and either suicide attempts in psychiatric populations or violence in criminally violent populations. However, none of these studies have compared cholesterol levels in violent and non-violent suicide attempters. The blood of 25 consecutive drug-free patients following a violent suicide attempt and of 27 patients following a non-violent suicide attempt by drug overdose was drawn in the 24 h following admission. Patients with a diagnosis of alcohol abuse and with cholesterol-lowering therapy were excluded. Age, sex, body mass index, psychiatric diagnosis and the physical conditions of the suicide attempt were investigated. Thirty-two healthy subjects were used as a control group. There were no differences between the groups in age, frequency of psychiatric diagnoses or body mass index. There was more women in the group of non-violent suicide attempters than in that of violent suicide attempters (P<0.001). In analyses controlling for sex and age, the serum cholesterol concentration was 30% lower (F(2,82)=15.8; P<0.0001) in the group of violent suicide attempters (147+/-54 mg/dl) than in the group of non-violent suicide attempters (209+/-38 mg/dl) or control subjects (213+/-46 mg/dl). Our results showed that low serum cholesterol level is associated with the violence of the suicide attempt and not with the suicide attempt itself. Further investigations are necessary to determine the usefulness of this easily accessible parameter as a potential risk indicator for violent acts such as violent suicidal behavior in susceptible individuals. PMID: 10963796 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10772398 Psychosom Med. 2000 Mar-Apr;62(2):205-11. Higher prevalence of depressive symptoms in middle-aged men with low serum cholesterol levels. Steegmans PH, Hoes AW, Bak AA, van der Does E, Grobbee DE. Department of Epidemiology, Erasmus University Medical School, Rotterdam, The Netherlands. OBJECTIVE: Investigators from several studies have reported a positive relationship between low cholesterol levels and death due to violent causes (eg, suicide and accidents), possibly mediated by depressive symptoms, aggression or hostility, or impulsivity. We set out to establish whether middle-aged men with chronically low cholesterol levels (< or =4.5 mmol/liter) have a higher risk of having depressive symptoms, according to scores on the Beck Depression Inventory, compared with a reference group of men with cholesterol levels between 6 and 7 mmol/liter. A similar comparison was also made for measures of anger, hostility, and impulsivity. METHODS: Cholesterol measurements were obtained as part of a population-based cholesterol screening study in 1990-1991. These levels were remeasured in 1993-1994. Only those whose cholesterol level remained in the same range were included in the study. Depressive symptoms were assessed by using the Beck Depression Inventory; anger, by questionnaires based on the Spielberger Anger Expression Scale and State-Trait Anger Scale; hostility, by the Buss-Durkee Hostility Inventory; and impulsivity, by the Eysenck and Eysenck Impulsivity Questionnaire. RESULTS: Men with chronically low cholesterol levels showed a consistently higher risk of having depressive symptoms (Beck Depression Inventory score > or =15 or > or =17) than the reference group, even after adjusting for age, energy intake, alcohol use, and presence of chronic diseases. No differences in anger, hostility, and impulsivity were observed between the two groups. CONCLUSIONS: Men with a lower cholesterol level (< or =4.5 mmol/liter) have a higher prevalence of depressive symptoms than those with a cholesterol level between 6 and 7 mmol/liter. These data may be important in the ongoing debate on the putative association between low cholesterol levels and violent death. PMID: 10772398 [PubMed - indexed for MEDLINE] ========================================================== The foregoing abstracts are of the more recent studies, but there are many more. A search of the National Institutes of Health (NIH) PubMed, using the search terms "cholesterol" + "violence" yields the following list, the overwhelming majority of which studies indicate a positive correlation between low cholesterol and violence or similar behaviors: 1: Vevera J, Fisar Z, Kvasnicka T, Zdenek H, Starkova L, Ceska R, Papezova H. Cholesterol-lowering therapy evokes time-limited changes in serotonergictransmission.Psychiatry Res. 2005 Feb 28;133(2-3):197-203. PMID: 15740995 [PubMed - in process] 2: Liu J, Wuerker A. Biosocial bases of aggressive and violent behavior--implications for nursingstudies.Int J Nurs Stud. 2005 Feb;42(2):229-41. PMID: 15680620 [PubMed - in process] 3: Kim YK, Myint AM. Clinical application of low serum cholesterol as an indicator for suicide riskin major depression.J Affect Disord. 2004 Aug;81(2):161-6. PMID: 15306143 [PubMed - indexed for MEDLINE] 4: Atmaca M, Kuloglu M, Tezcan E, Ustundag B. Serum leptin and cholesterol levels in schizophrenic patients with and withoutsuicide attempts.Acta Psychiatr Scand. 2003 Sep;108(3):208-14. PMID: 12890276 [PubMed - indexed for MEDLINE] 5: Ledochowski M, Murr C, Sperner-Unterweger B, Neurauter G, Fuchs D. Association between increased serum cholesterol and signs of depressive mood.Clin Chem Lab Med. 2003 Jun;41(6):821-4. PMID: 12880147 [PubMed - indexed for MEDLINE] 6: Vevera J, Zukov I, Morcinek T, Papezova H. Cholesterol concentrations in violent and non-violent women suicide attempters.Eur Psychiatry. 2003 Feb;18(1):23-7. PMID: 12648892 [PubMed - indexed for MEDLINE] 7: Golaszewski T, Barr D, Pronk N. Development of assessment tools to measure organizational support for employeehealth.Am J Health Behav. 2003 Jan-Feb;27(1):43-54. PMID: 12500951 [PubMed - indexed for MEDLINE] 8: Tochigi M, Umekage T, Otani T, Kato T, Iwanami A, Asukai N, Sasaki T, KatoN. Serum cholesterol, uric acid and cholinesterase in victims of the Tokyo subwaysarin poisoning: a relation with post-traumatic stress disorder.Neurosci Res. 2002 Nov;44(3):267-72. PMID: 12413655 [PubMed - indexed for MEDLINE] 9: Cantor CH. An ecological perspective of cholesterol.Med J Aust. 2002 Jun 3;176(11):564. No abstract available. PMID: 12064996 [PubMed - indexed for MEDLINE] 10: Repo-Tiihonen E, Halonen P, Tiihonen J, Virkkunen M. Total serum cholesterol level, violent criminal offences, suicidal behavior,mortality and the appearance of conduct disorder in Finnish male criminaloffenders with antisocial personality disorder.Eur Arch Psychiatry Clin Neurosci. 2002 Feb;252(1):8-11. PMID: 12056583 [PubMed - indexed for MEDLINE] 11: Tripodianakis J, Markianos M, Sarantidis D, Agouridaki M. Biogenic amine turnover and serum cholesterol in suicide attempt.Eur Arch Psychiatry Clin Neurosci. 2002 Feb;252(1):38-43. PMID: 12056581 [PubMed - indexed for MEDLINE] 12: Agargun MY, Sekeroglu MR, Kara H, Ozer OA, Tombul T, Kiran U, Selvi Y. Sleep-related violence and low serum cholesterol: a preliminary study.Psychiatry Clin Neurosci. 2002 Apr;56(2):195-8. PMID: 11952924 [PubMed - indexed for MEDLINE] 13: Menotti A, Blackburn H, Kromhout D, Nissinen A, Adachi H, Lanti M. Cardiovascular risk factors as determinants of 25-year all-cause mortality inthe seven countries study.Eur J Epidemiol. 2001;17(4):337-46. PMID: 11767959 [PubMed - indexed for MEDLINE] 14: Huang TL. Serum cholesterol levels in mood disorders associated with physical violence orsuicide attempts in Taiwanese.Chang Gung Med J. 2001 Sep;24(9):563-8. PMID: 11725626 [PubMed - indexed for MEDLINE] 15: Terao T, Whale R. High serum cholesterol and suicide risk.Am J Psychiatry. 2001 May;158(5):824-5. No abstract available. PMID: 11329428 [PubMed - indexed for MEDLINE] 16: Davidson MH. Safety profiles for the HMG-CoA reductase inhibitors: treatment and trust.Drugs. 2001;61(2):197-206. Review. PMID: 11270938 [PubMed - indexed for MEDLINE] 17: Hillbrand M, Waite BM, Miller DS, Spitz RT, Lingswiler VM. Serum cholesterol concentrations and mood states in violent psychiatricpatients: an experience sampling study.J Behav Med. 2000 Dec;23(6):519-29. PMID: 11199085 [PubMed - indexed for MEDLINE] 18: Manfredini R, Caracciolo S, Salmi R, Boari B, Tomelli A, Gallerani M. The association of low serum cholesterol with depression and suicidalbehaviours: new hypotheses for the missing link.J Int Med Res. 2000 Nov-Dec;28(6):247-57. Review. PMID: 11191718 [PubMed - indexed for MEDLINE] 19: McAllister M. Domestic violence: a life-span approach to assessment and intervention.Lippincotts Prim Care Pract. 2000 Mar-Apr;4(2):174-89; quiz 190-2. PMID: 11143628 [PubMed - indexed for MEDLINE] 20: Muldoon MF, Manuck SB, Mendelsohn AB, Kaplan JR, Belle SH. Cholesterol reduction and non-illness mortality: meta-analysis of randomisedclinical trials.BMJ. 2001 Jan 6;322(7277):11-5. PMID: 11141142 [PubMed - indexed for MEDLINE] 21: Golomb BA, Stattin H, Mednick S. Low cholesterol and violent crime.J Psychiatr Res. 2000 Jul-Oct;34(4-5):301-9. PMID: 11104842 [PubMed - indexed for MEDLINE] 22: Stewart RA, Sharples KJ, North FM, Menkes DB, Baker J, Simes J. Long-term assessment of psychological well-being in a randomizedplacebo-controlled trial of cholesterol reduction with pravastatin. The LIPIDStudy Investigators.Arch Intern Med. 2000 Nov 13;160(20):3144-52. PMID: 11074745 [PubMed - indexed for MEDLINE] 23: Huang T, Wu S. Serum cholesterol levels in paranoid and non-paranoid schizophrenia associatedwith physical violence or suicide attempts in Taiwanese.Psychiatry Res. 2000 Oct 30;96(2):175-8. PMID: 11063790 [PubMed - indexed for MEDLINE] 24: Terao T, Nakamura J, Yoshimura R, Ohmori O, Takahashi N, Kojima H, Soeda S,Shinkai T, Nakano H, Okuno T. Relationship between serum cholesterol levels andmeta-chlorophenylpiperazine-induced cortisol responses in healthy men and women.Psychiatry Res. 2000 Oct 30;96(2):167-73. PMID: 11063789 [PubMed - indexed for MEDLINE] 25: Alvarez JC, Cremniter D, Gluck N, Quintin P, Leboyer M, Berlin I, TherondP, Spreux-Varoquaux O. Low serum cholesterol in violent but not in non-violent suicide attempters.Psychiatry Res. 2000 Aug 21;95(2):103-8. PMID: 10963796 [PubMed - indexed for MEDLINE] 26: Steegmans PH, Hoes AW, Bak AA, van der Does E, Grobbee DE. Higher prevalence of depressive symptoms in middle-aged men with low serumcholesterol levels.Psychosom Med. 2000 Mar-Apr;62(2):205-11. PMID: 10772398 [PubMed - indexed for MEDLINE] 27: Tanskanen A, Vartiainen E, Tuomilehto J, Viinamaki H, Lehtonen J, Puska P. High serum cholesterol and risk of suicide.Am J Psychiatry. 2000 Apr;157(4):648-50. PMID: 10739432 [PubMed - indexed for MEDLINE] 28: Seneviratne SL, Warnasooriya WM, Gunatilake SB, Fonseka MM, Gunawardena MK,de Silva HJ. Serum cholesterol concentrations in parasuicide.Ceylon Med J. 1999 Mar;44(1):11-3. PMID: 10643091 [PubMed - indexed for MEDLINE] 29: Hibbeln JR, Umhau JC, George DT, Shoaf SE, Linnoila M, Salem N Jr. Plasma total cholesterol concentrations do not predict cerebrospinal fluidneurotransmitter metabolites: implications for the biophysical role of highlyunsaturated fatty acids.Am J Clin Nutr. 2000 Jan;71(1 Suppl):331S-8S. PMID: 10617992 [PubMed - indexed for MEDLINE] 30: Steinert T, Woelfle M, Gebhardt RP. No correlation of serum cholesterol levels with measures of violence inpatients with schizophrenia and non-psychotic disorders.Eur Psychiatry. 1999 Oct;14(6):346-8. PMID: 10572367 [PubMed - indexed for MEDLINE] 31: Apter A, Laufer N, Bar-Sever M, Har-Even D, Ofek H, Weizman A. Serum cholesterol, suicidal tendencies, impulsivity, aggression, and depressionin adolescent psychiatric inpatients.Biol Psychiatry. 1999 Aug 15;46(4):532-41. PMID: 10459404 [PubMed - indexed for MEDLINE] 32: Ilveskoski E, Perola M, Lehtimaki T, Laippala P, Savolainen V, Pajarinen J,Penttila A, Lalu KH, Mannikko A, Liesto KK, Koivula T, Karhunen PJ. Age-dependent association of apolipoprotein E genotype with coronary and aorticatherosclerosis in middle-aged men: an autopsy study.Circulation. 1999 Aug 10;100(6):608-13. PMID: 10441097 [PubMed - indexed for MEDLINE] 33: Alvarez JC, Cremniter D, Lesieur P, Gregoire A, Gilton A, Macquin-Mavier I,Jarreau C, Spreux-Varoquaux O. Low blood cholesterol and low platelet serotonin levels in violent suicideattempters.Biol Psychiatry. 1999 Apr 15;45(8):1066-9. PMID: 10386194 [PubMed - indexed for MEDLINE] 34: New AS, Sevin EM, Mitropoulou V, Reynolds D, Novotny SL, Callahan A,Trestman RL, Siever LJ. Serum cholesterol and impulsivity in personality disorders.Psychiatry Res. 1999 Feb 22;85(2):145-50. PMID: 10220005 [PubMed - indexed for MEDLINE] 35: Klein JD, Graff CA, Santelli JS, Hedberg VA, Allan MJ, Elster AB. Developing quality measures for adolescent care: validity of adolescents'self-reported receipt of preventive services.Health Serv Res. 1999 Apr;34(1 Pt 2):391-404. PMID: 10199683 [PubMed - indexed for MEDLINE] 36: Puska P, Vartiainen E, Tuomilehto J, Salomaa V, Nissinen A. Changes in premature deaths in Finland: successful long-term prevention ofcardiovascular diseases.Bull World Health Organ. 1998;76(4):419-25. PMID: 9803593 [PubMed - indexed for MEDLINE] 37: Weinberger RF. Cholesterol and violence: is there a connection?Ann Intern Med. 1998 Oct 15;129(8):669-70. No abstract available. PMID: 9786821 [PubMed - indexed for MEDLINE] 38: Faustman WO, Ringo DL, Lindley SE. Cholesterol and violence: is there a connection?Ann Intern Med. 1998 Oct 15;129(8):669; author reply 669-70. No abstractavailable. PMID: 9786820 [PubMed - indexed for MEDLINE] 39: Goldstein MR. Cholesterol and violence: is there a connection?Ann Intern Med. 1998 Oct 15;129(8):668-9; author reply 669-70. No abstractavailable. PMID: 9786819 [PubMed - indexed for MEDLINE] 40: Nash SD. Cholesterol and violence: is there a connection?Ann Intern Med. 1998 Oct 15;129(8):668; author reply 669-70. No abstractavailable. PMID: 9786818 [PubMed - indexed for MEDLINE] 41: Schlienger JL, Goichot B, Pradignac A. [Cholesterolemia and pathology: update]Rev Med Interne. 1998 Mar;19(3):180-4. Review. French. PMID: 9775138 [PubMed - indexed for MEDLINE] 42: Hibbeln JR, Umhau JC, Linnoila M, George DT, Ragan PW, Shoaf SE, VaughanMR, Rawlings R, Salem N Jr. A replication study of violent and nonviolent subjects: cerebrospinal fluidmetabolites of serotonin and dopamine are predicted by plasma essential fattyacids.Biol Psychiatry. 1998 Aug 15;44(4):243-9. PMID: 9715355 [PubMed - indexed for MEDLINE] 43: Hibbeln JR, Linnoila M, Umhau JC, Rawlings R, George DT, Salem N Jr. Essential fatty acids predict metabolites of serotonin and dopamine incerebrospinal fluid among healthy control subjects, and early- and late-onsetalcoholics.Biol Psychiatry. 1998 Aug 15;44(4):235-42. PMID: 9715354 [PubMed - indexed for MEDLINE] 44: Kaplan JR, Muldoon MF, Manuck SB, Mann JJ. Assessing the observed relationship between low cholesterol andviolence-related mortality. Implications for suicide risk.Ann N Y Acad Sci. 1997 Dec 29;836:57-80. Review. PMID: 9616794 [PubMed - indexed for MEDLINE] 45: Mufti RM, Balon R, Arfken CL. Low cholesterol and violence.Psychiatr Serv. 1998 Feb;49(2):221-4. PMID: 9575009 [PubMed - indexed for MEDLINE] 46: Golomb BA. Cholesterol and violence: is there a connection?Ann Intern Med. 1998 Mar 15;128(6):478-87. Review. PMID: 9499332 [PubMed - indexed for MEDLINE] 47: Boston PF, Dursun SM, Reveley MA. Cholesterol and mental disorder.Br J Psychiatry. 1996 Dec;169(6):682-9. Review. PMID: 8968624 [PubMed - indexed for MEDLINE] 48: Virkkunen M, Eggert M, Rawlings R, Linnoila M. A prospective follow-up study of alcoholic violent offenders and fire setters.Arch Gen Psychiatry. 1996 Jun;53(6):523-9. PMID: 8639035 [PubMed - indexed for MEDLINE] 49: Golomb B. Low cholesterol and violence.Arch Intern Med. 1995 Dec 11-25;155(22):2485. No abstract available. PMID: 7503611 [PubMed - indexed for MEDLINE] 50: Strandberg TE, Salomaa VV, Vanhanen HT, Naukkarinen VA, Sarna SJ, MiettinenTA. Mortality in participants and non-participants of a multifactorial preventionstudy of cardiovascular diseases: a 28 year follow up of the HelsinkiBusinessmen Study.Br Heart J. 1995 Oct;74(4):449-54. PMID: 7488463 [PubMed - indexed for MEDLINE] 51: Strandberg T. Serum cholesterol concentrations in parasuicide. No association between lowcholesterol and violent death.BMJ. 1995 Sep 23;311(7008):807-8. No abstract available. PMID: 7580453 [PubMed - indexed for MEDLINE] 52: Gallerani M, Manfredini R, Caracciolo S, Scapoli C, Molinari S, Fersini C. Serum cholesterol concentrations in parasuicide.BMJ. 1995 Jun 24;310(6995):1632-6. PMID: 7795448 [PubMed - indexed for MEDLINE] 53: Schwandt P, Richter WO, Sonnichsen AC. Lowering high plasma cholesterol levels is not dangerous.Arch Intern Med. 1995 May 8;155(9):985. No abstract available. PMID: 7726707 [PubMed - indexed for MEDLINE] 54: Penttinen J. Hypothesis: low serum cholesterol, suicide, and interleukin-2.Am J Epidemiol. 1995 Apr 15;141(8):716-8. PMID: 7709913 [PubMed - indexed for MEDLINE] 55: Friedman EH. Neurobiology of cholesterol and violent behavior.Arch Intern Med. 1995 Mar 13;155(5):543-4. No abstract available. PMID: 7864712 [PubMed - indexed for MEDLINE] 56: Serjeant ME. Cholesterol and violent behavior.Arch Intern Med. 1995 Mar 13;155(5):544. No abstract available. PMID: 7726951 [PubMed - indexed for MEDLINE] 57: Toshima H, Koga Y, Menotti A, Keys A, Blackburn H, Jacobs DR, SeccarecciaF. The seven countries study in Japan. Twenty-five-year experience incardiovascular and all-causes deaths.Jpn Heart J. 1995 Mar;36(2):179-89. PMID: 7596038 [PubMed - indexed for MEDLINE] 58: Hillbrand M, Spitz RT, Foster HG. Serum cholesterol and aggression in hospitalized male forensic patients.J Behav Med. 1995 Feb;18(1):33-43. PMID: 7595950 [PubMed - indexed for MEDLINE] 59: Richter WO. [Increased autoaggression caused by cholesterol lowering drugs?]Fortschr Med. 1994 Dec 20;112(35-36):507-8. German. No abstract available. PMID: 7843681 [PubMed - indexed for MEDLINE] 60: Paunio M, Heinonen OP, Virtamo J, Klag MJ, Manninen V, Albanes D, ComstockGW. HDL cholesterol and mortality in Finnish men with special reference to alcoholintake.Circulation. 1994 Dec;90(6):2909-18. PMID: 7994838 [PubMed - indexed for MEDLINE] 61: Boston PF, Dursun SM, Reveley MA. Cholesterol and violent death. Other studies exist.BMJ. 1994 Nov 5;309(6963):1228. No abstract available. PMID: 7987161 [PubMed - indexed for MEDLINE] 62: Hughes M. Cholesterol and violent death. Diets, violence, and civilization.BMJ. 1994 Nov 5;309(6963):1228. No abstract available. PMID: 7987160 [PubMed - indexed for MEDLINE] 63: Owens D. Cholesterol and violent death. Clinical importance is questionable.BMJ. 1994 Nov 5;309(6963):1228. No abstract available. PMID: 7987159 [PubMed - indexed for MEDLINE] 64: Kaplan JR, Shively CA, Fontenot MB, Morgan TM, Howell SM, Manuck SB,Muldoon MF, Mann JJ. Demonstration of an association among dietary cholesterol, central serotonergicactivity, and social behavior in monkeys.Psychosom Med. 1994 Nov-Dec;56(6):479-84. PMID: 7532867 [PubMed - indexed for MEDLINE] 65: Vartiainen E, Puska P, Pekkanen J, Tuomilehto J, Lonnqvist J, Ehnholm C. Serum cholesterol concentration and mortality from accidents, suicide, andother violent causes.BMJ. 1994 Aug 13;309(6952):445-7. PMID: 7920128 [PubMed - indexed for MEDLINE] 66: Santiago JM, Dalen JE. Cholesterol and violent behavior.Arch Intern Med. 1994 Jun 27;154(12):1317-21. Review. Erratum in: Arch InternMed 1994 Sep 26;154(18):2047. PMID: 8002683 [PubMed - indexed for MEDLINE] 67: Ernst E. Cholesterol and violence: more questions than answers.Br J Hosp Med. 1994 Apr 6-19;51(7):329-30, 332-3. No abstract available. PMID: 8081561 [PubMed - indexed for MEDLINE] 68: Spitz RT, Hillbrand M, Foster HG Jr. Serum cholesterol levels and frequency of aggression.Psychol Rep. 1994 Apr;74(2):622. PMID: 8197299 [PubMed - indexed for MEDLINE] 69: Lewis B, Tikkanen MJ. Low blood total cholesterol and mortality: causality, consequence andconfounders.Am J Cardiol. 1994 Jan 1;73(1):80-5. No abstract available. PMID: 8279383 [PubMed - indexed for MEDLINE] 70: Dursun SM, Reveley MA. Low serum cholesterol and serotonin receptor subtypes.Br J Psychiatry. 1993 Sep;163:417-8. No abstract available. PMID: 8401981 [PubMed - indexed for MEDLINE] 71: Ong HT. Cholesterol reduction therapy: a double-edged knife.Med J Malaysia. 1993 Jun;48(2):107-12. Review. Erratum in: Med J Malaysia 1993Sep;48(3):iv. PMID: 8350783 [PubMed - indexed for MEDLINE] 72: Gray RF, Corrigan FM, Strathdee A, Skinner ER, van Rhijn AG, Horrobin DF. Cholesterol metabolism and violence: a study of individuals convicted ofviolent crimes.Neuroreport. 1993 Jun;4(6):754-6. PMID: 8347820 [PubMed - indexed for MEDLINE] 73: Hawthon K, Cowen P, Owens D, Bond A, Elliott M. Low serum cholesterol and suicide.Br J Psychiatry. 1993 Jun;162:818-25. PMID: 7980726 [PubMed - indexed for MEDLINE] 74: Epstein FH. Low serum cholesterol and death due to accidents, violence, or suicide.Lancet. 1993 May 1;341(8853):1150. No abstract available. PMID: 8097829 [PubMed - indexed for MEDLINE] 75: Schuit AJ, Dekker JM, Schouten EG, Kok FJ. Low serum cholesterol and death due to accidents, violence, or suicide.Lancet. 1993 Mar 27;341(8848):827. No abstract available. Erratum in: Lancet1993 May 1;341(8853):1150. PMID: 8096023 [PubMed - indexed for MEDLINE] 76: Hillbrand M, Foster HG. Serum cholesterol levels and severity of aggression.Psychol Rep. 1993 Feb;72(1):270. No abstract available. PMID: 8451361 [PubMed - indexed for MEDLINE] 77: Kromhout D, Katan MB, Menotti A, Keys A, Bloemberg B. Serum cholesterol and long-term death rates from suicide, accidents, orviolence. Seven Countries Study Group.Lancet. 1992 Aug 1;340(8814):317. No abstract available. PMID: 1353240 [PubMed - indexed for MEDLINE] 78: Ball M, Mann J. Cholesterol lowering--the sense and the sensationalism.N Z Med J. 1992 Jul 22;105(938):283-4. No abstract available. PMID: 1386655 [PubMed - indexed for MEDLINE] 79: Samuel P. Violent death and cholesterol reduction.Lancet. 1992 Jul 4;340(8810):50-1. No abstract available. PMID: 1351622 [PubMed - indexed for MEDLINE] 80: Peer DA, Stoukides CA. Association of low cholesterol with aggression.Ann Pharmacother. 1992 Jun;26(6):785-6. Review. No abstract available. PMID: 1611162 [PubMed - indexed for MEDLINE] 81: Oliver MF. Low serum cholesterol and suicide.Lancet. 1992 May 9;339(8802):1168-9. No abstract available. PMID: 1349387 [PubMed - indexed for MEDLINE] 82: Modest G. Long-term mortality after primary prevention for cardiovascular disease.JAMA. 1992 Apr 22-29;267(16):2184; author reply 2185-6. No abstract available.Erratum in: JAMA 1993 Feb 3;269(5):591. PMID: 1556788 [PubMed - indexed for MEDLINE] 83: Engelberg H. Low serum cholesterol and suicide.Lancet. 1992 Mar 21;339(8795):727-9. PMID: 1347593 [PubMed - indexed for MEDLINE] 84: Rossouw JE, Canner PL, Hulley SB. Deaths from injury, violence, and suicide in secondary prevention trials ofcholesterol lowering.N Engl J Med. 1991 Dec 19;325(25):1813. No abstract available. PMID: 1834942 [PubMed - indexed for MEDLINE] 85: Kaplan JR, Manuck SB, Shively C. The effects of fat and cholesterol on social behavior in monkeys.Psychosom Med. 1991 Nov-Dec;53(6):634-42. PMID: 1758948 [PubMed - indexed for MEDLINE] 86: Pekkanen J, Poikolainen K. [Cholesterol-lowering drugs and violent deaths]Duodecim. 1991;107(14):1145-8. Finnish. No abstract available. PMID: 1670510 [PubMed - indexed for MEDLINE] 87: Wysowski DK, Gross TP. Deaths due to accidents and violence in two recent trials ofcholesterol-lowering drugs.Arch Intern Med. 1990 Oct;150(10):2169-72. PMID: 2222103 [PubMed - indexed for MEDLINE] 88: [No authors listed] Lowering cholesterol concentrations and mortality.BMJ. 1990 Sep 15;301(6751):552-5. No abstract available. PMID: 2271045 [PubMed - indexed for MEDLINE] 89: Wigle DT, Mao Y, Semenciw R, McCann C, Davies JW. Premature deaths in Canada: impact, trends and opportunities for prevention.Can J Public Health. 1990 Sep-Oct;81(5):376-81. Erratum in: Can J Public Health1991 Jan-Feb;82(1):26. PMID: 2253155 [PubMed - indexed for MEDLINE] 90: Muldoon MF, Manuck SB, Matthews KA. Lowering cholesterol concentrations and mortality: a quantitative review ofprimary prevention trials.BMJ. 1990 Aug 11;301(6747):309-14. PMID: 2144195 [PubMed - indexed for MEDLINE] 91: Pekkanen J, Nissinen A, Punsar S, Karvonen MJ. Serum cholesterol and risk of accidental or violent death in a 25-yearfollow-up. The Finnish cohorts of the Seven Countries Study.Arch Intern Med. 1989 Jul;149(7):1589-91. PMID: 2742433 [PubMed - indexed for MEDLINE] 92: Kivela SL, Nissinen A, Ketola A, Punsar S, Puska P, Karvonen M. Alcohol consumption and mortality in aging or aged Finnish men.J Clin Epidemiol. 1989;42(1):61-8. Erratum in: J Clin Epidemiol 1989;42(7):701. PMID: 2913188 [PubMed - indexed for MEDLINE] 93: Farchi G, Menotti A, Conti S. Coronary risk factors and survival probability from coronary and other causesof death.Am J Epidemiol. 1987 Sep;126(3):400-8. PMID: 3618576 [PubMed - indexed for MEDLINE] 94: Virkkunen ME, Horrobin DF, Jenkins DK, Manku MS. Plasma phospholipid essential fatty acids and prostaglandins in alcoholic,habitually violent, and impulsive offenders.Biol Psychiatry. 1987 Sep;22(9):1087-96. PMID: 2958095 [PubMed - indexed for MEDLINE] 95: Gualandri V, Franceschini G, Sirtori CR, Gianfranceschi G, Orsini GB,Cerrone A, Menotti A. AIMilano apoprotein identification of the complete kindred and evidence of adominant genetic transmission.Am J Hum Genet. 1985 Nov;37(6):1083-97. PMID: 3936350 [PubMed - indexed for MEDLINE] 96: Virkkunen M. Lipid Research Clinics Coronary Primary Prevention Trial results.JAMA. 1985 Feb 1;253(5):635-6. No abstract available. PMID: 3968799 [PubMed - indexed for MEDLINE] 97: Virkkunen M, Penttinen H. Serum cholesterol in aggressive conduct disorder: a preliminary study.Biol Psychiatry. 1984 Mar;19(3):435-9. No abstract available. PMID: 6722234 [PubMed - indexed for MEDLINE] 98: Virkkunen M. Serum cholesterol levels in homicidal offenders. A low cholesterol level isconnected with a habitually violent tendency under the influence of alcohol.Neuropsychobiology. 1983;10(2-3):65-9. PMID: 6674827 [PubMed - indexed for MEDLINE] 99: [No authors listed] W.H.O. cooperative trial on primary prevention of ischaemic heart disease usingclofibrate to lower serum cholesterol: mortality follow-up. Report of theCommittee of Principal Investigators.Lancet. 1980 Aug 23;2(8191):379-85. PMID: 6105515 [PubMed - indexed for MEDLINE] 100: Kozararevic D, McGee D, Vojvodic N, Racic Z, Dawber T, Gordon T, Zukel W. Frequency of alcohol consumption and morbidity and mortality: The YugoslaviaCardiovascular Disease Study.Lancet. 1980 Mar 22;1(8169):613-6. PMID: 6102625 [PubMed - indexed for MEDLINE] 101: Carruthers M, Taggart P. Vagotonicity of violence: biochemical and cardiac responses to violent filmsand television programmes.Br Med J. 1973 Aug 18;3(5876):384-9. No abstract available. PMID: 4730188 [PubMed - indexed for MEDLINE] 102: Mushin A, Morgan G. Ocular injury in the battered baby syndrome. Report of two cases.Br J Ophthalmol. 1971 May;55(5):343-7. No abstract available. PMID: 5579167 [PubMed - indexed for MEDLINE] "Sharon Hope" <shope@anet.net> wrote in message news:DPadnWjXDrIZJabfRVn-sQ@comcast.com... > http://aje.oupjournals.org/cgi/content/abstract/161/7/691 > > Association of Serum Cholesterol and History of School Suspension among > School-age Children and Adolescents in the United States > Jian Zhang1, Matthew F. Muldoon2, Robert E. McKeown3 and Steven P. Cuffe4 > 1 Division of Health and Family Studies, Institute for Families in > Society, University of South Carolina, Columbia, SC > 2 Center for Clinical Pharmacology, University of Pittsburgh School of > Medicine, Pittsburgh, PA > 3 Department of Epidemiology and Biostatistics, Arnold School of Public > Health, University of South Carolina, Columbia, SC > 4 Department of Neuropsychiatry and Behavioral Science, Division of Child > and Adolescent Psychiatry, University of South Carolina School of > Medicine, Columbia, SC > > Correspondence to Dr. Jian Zhang, 4770 Buford Highway, MS K-24, Atlanta, > GA 30341 (e-mail: bvw2@cdc.gov). > > The dietary guidelines developed for adults have been extended to > children, but the role of serum cholesterol in the neurodevelopment of > children is poorly understood. In the Third National Health and Nutrition > Examination Survey (1988-1994), serum total cholesterol was measured in > 4,852 children aged 6-16 years. Psychosocial development was evaluated by > interviewing the mother regarding the child's history of school suspension > or expulsion and difficulty in getting along with others. After adjustment > for family socioeconomic status, maternal marital status and education, > children's nutrition, and academic performance, the odds ratios of > children with various concentrations of total cholesterol showed the > children to be equally comfortable in their own peer subculture and not to > be different in the proportion that had seen a mental health professional. > However, non-African-American children with a serum total cholesterol > concentration below the 25th percentile (<145 mg/dl) were almost threefold > more likely to have been suspended or expelled from schools than their > peers with total cholesterol at or above the 25th percentile (odds ratio = > 2.96, 95% confidence interval: 1.55, 5.64). The authors concluded that, > among non-African-American children, low total cholesterol is associated > with school suspension or expulsion and that low total cholesterol may be > a risk factor for aggression or a risk marker for other biologic variables > that predispose to aggression. > > > adolescent psychology; child psychology; cholesterol; juvenile > delinquency; United States > > > > > -------------------------------------------------------------------------------- > Abbreviations: CI, confidence interval; DISC, Dietary Intervention Study > in Children; NHANES III, Third National Health and Nutrition Examination > Survey; STRIP, Special Turku Coronary Risk Factor Intervention Project; > WRAT-R, Wide Range Achievement Test, Revised > > > >
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