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Lipids and essential fatty acids in patients presenting with self-harm

  • Malcolm R. Garland (a1), Brian Hallahan (a1), Mairead McNamara (a2), Philip A. Carney (a1), Helen Grimes (a3), Joseph R. Hibbeln (a4), Andrew Harkin (a2) and Ronan M. Conroy (a5)...

Abstract

Background

Low cholesterol has been reliably demonstrated in people who self-harm.

Aims

To determine whether people who self-harm also have low levels of essential fatty acids (EFAs) and to examine associations between the EFAs and serotonergic function.

Method

Depression, impulsivity and suicidal intent were measured in patients with self-harm (n=40) and matched controls, together with plasma lipids and EFAs. Platelet serotonergic studies were carried out in a subgroup (n=27).

Results

Patients with self-harm had significantly more pathology on all psychometric measures, lower mean total cholesterol levels (418 (s.d. =0.93) v. 4.87 (s.d.=0.83) mmol/l, P=0.003) and lower mean total EFA levels (89. 5 (15.6) v. 103.7 (17.1) μg/ml, P=0.0001) than controls after adjustment for confounding variables. Total n-3 and n-6 EFA levels were also significantly lower. Impulsivity and depression scores were significantly inversely correlated with both n-6 EFAs and n-3 EFAs, but were not associated with total or low-density lipoprotein cholesterol levels. Platelet serotonergic measures did not differ between groups, and were not related to psychobiological measures.

Conclusions

Lower plasma EFA levels combined with low cholesterol concentrations were associated with self-harm as well as impulsivity and affect. This was not related to platelet serotonergic measures.

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Copyright

Corresponding author

Dr Malcolm R. Garland, St Ita's Hospital, Portrane, County Dublin, Ireland. Email: mgarland@ireland.com

Footnotes

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See pp. 118-122, this issue.

Declaration of interest

None

Footnotes

References

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Allain, C. C., Poon, L. S., Chan, C. S. G., et al (1974) Enzymatic determination of total serum cholesterol. Clinical Chemistry, 20, 470475.
Alvarez, J. C., Cremniter, D., Lesieur, P., et al (1999) Low blood cholesterol and low platelet serotonin levels in violent suicide attempters. Biological Psychiatry, 45, 10661069.
Barratt, E. S. (1994) Impulsiveness and aggression. In Violence and Mental disorder: Developments in Risk Assessment (eds Monahan, J. & Steadman, H. J.), pp. 6179. University of Chicago Press.
Beck, A. T., Ward, C. H., Mendelson, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.
Beck, A. T., Herman, J. & Schuyler, D. (1974) Development of suicidal intent scales. In The Prediction of Suicide (eds Beck, A.T., Resnik, H. L. P. & Lettieri, D.J.), pp. 4548. Charles Press.
Cohen, J. H., Kristal, A. R., Neumark-Sztainaer, D., et al (2002) Psychological distress is associated with unhealthful dietary practices. Journal of the American Dietetic Association, 102, 699703.
de la Presa Owens, S. & Innis, S. M. (1999) Docosahexaenoic and arachidonic acid prevent a decrease in dopaminergic and serotoninergic neurotransmitters in frontal cortex caused by a linoleic and alpha-linolenic acid deficient diet in formula-fed piglets. Journal of Nutrition, 129, 20882093.
Delion, S., Chalon, S., Guilloteau, D., et al (1996) Alpha-Linolenic acid dietary deficiency alters age-related changes of dopaminergic and serotoninergic neurotransmission in the rat frontal cortex. Journal of Neurochemistry, 66, 15821591.
Engelberg, H. (1992) Lower serum cholesterol and suicide. Lancet, 339, 727729.
Garland, M., Hickey, D., Corvin, A., et al (2000) Total serum cholesterol in relation to psychological correlates in parasuicide. British Journal of Psychiatry, 177, 7783.
Gulyaeva, N. V., Levshina, I. P. & Obidin, A. B. (1989) Indices of free-radical oxidation of lipids and antiradical protection of the brain – neurochemical correlates of development of the general adaptation syndrome. Neuroscience Behavior and Physiology, 19, 376382.
Hallahan, B., & Garland, M. R. (2005) Essential fatty acids and mental health. British Journal of Psychiatry, 186, 275277.
Hallahan, B., Hibbeln, J. R., Davis, J. M., et al (2007) Omega-3 fatty acid supplementation in patients with recurrent self-harm. Single-centre double-blind randomised controlled trial. British Journal of Psychiatry, 190, 118122.
Harris, W. S., Hustvedt, B. E., Hagen, E., et al (1997) N-3 fatty acids and chylomicron metabolism in the rat. Journal of Lipid Research, 38, 503515.
Heron, D. S., Shinitzky, M., Hershkowitz, M., et al (1980) Lipid fluidity markedly modulates the binding of serotonin to mouse brain membranes. Proceedings of the National Academy of Sciences of the USA, 77, 74637467.
Hibbeln, J. R. (1999) Membrane lipids in relation to depression. In Phospholipid Spectrum Disorder in Psychiatry (eds Peet, M., Glen, L. & Horrobin, D. F.), pp. 195210. Marius Press.
Hibbeln, J. R. (2002) Seafood consumption, the DHA content of mothers' milk and prevalence rates of postpartum depression: across-national, ecological analysis. Journal of Affective Disorders, 69, 1529.
Hirayama, T. (1990) Life-Style and Mortality: A Large Census-Based Cohort Study in Japan. Karger.
Huan, M., Hamazaki, K., Sun, Y., et al (2004) Suicide attempt and n-3 fatty acid levels in red blood cells: a case control study in China. Biological Psychiatry, 56, 490496.
Kelly, J. P., Nicolau, G., Redmond, A., et al (1999) The effect of treatment with a new antidepressant, INN 00835, on platelet serotonin uptake in depressed patients. Journal of Affective Disorders, 55, 231235.
Lester, D. (2002) Serum cholesterol levels and suicide: a meta-analysis. Suicide and Life Threatening Behavior, 32, 333346.
Levitsky, D. A. & Strupp, B. J. (1995) Malnutrition and the brain: changing concepts, changing concerns. Journal of Nutrition, 125, 2212S2220S.
Lozoff, B., Jimenez, E. & Wolf, A. W. (1991) Long-term developmental outcome of infants with iron deficiency. New England Journal of Medicine, 325, 687694.
Mann, J.J. (2003) Neurobiology of suicidal behaviour. Nature Reviews Neuroscience, 4, 819828.
Muldoon, M. F., Manuck, S. B. & Matthews, K. A. (1990) Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. BMJ, 301, 309314.
Muldoon, M. F., Manuck, S. B., Mendelsohn, A. B., et al (2001) Cholesterol reduction and non-illness mortality: meta-analysis of randomised clinical trials. BMJ, 322, 1115.
Owens, M.J. & Nemeroff, C. B. (1994) Role of serotonin in the pathophysiology of depression: focus on the serotonin transporter. Clinical Chemistry, 40, 288295.
Pardridge, W. M. & Mietus, L. J. (1980) Palmitate and cholesterol transport through the blood-brain barrier. Journal of Neurochemistry, 34, 463466.
Peet, M., Ramchand, C. N., Lee, J., et al (1998) Association of the Ban I dimorphic site at the human cytosolic phospholipase A2 gene with schizophrenia. Psychiatric Genetics, 81, 9192.
Roggenbach, J., Muller-Oerlinghausen, B. & Franke, L. (2002) Suicidality, impulsivity and aggression – is there a link to 5H1AA concentration in the cerebrospinal fluid? Psychiatry Research, 113, 193206.
Royal College of Psychiatrists (1986) Alcohol: Our Favourite Drug. Tavistock Publications.
Scanlon, S. M., Williams, D. C. & Schloss, P. (2001) Membrane cholesterol modulates serotonin transporter activity. Biochemistry, 40, 1050710513.
Sosnovskii, A. S., Balashova, T. S., Pirogova, G. V., et al (1993) Antioxidant enzymatic activity in the limbic-reticular structures of the rat brain alter short-term immobilization. Biulleten ‘Eksperimental'noi Biologii i Meditsiny, 115, 612614.
Stevens, L. J., Zentall, S. S., Deck, J. L., et al (1995) Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. American Journal of Clinical Nutrition, 62, 761768.
Stewart, R. A., Sharples, K. J., North, F. M., et al (2000) Long-term assessment of psychological well-being in a randomized placebo-controlled trial of cholesterol reduction with pravastatin. The LIPID Study Investigators. Archives of Internal Medicine, 160, 31443152.
Tanskanen, A., Hibbeln, J. R., Hintikka, J., et al (2001) Fish consumption, depression, and suicidality in a general population. Archives of General Psychiatry, 58, 512513.
Terao, T., Nakamura, J., Yoshimura, R., et al (2000) Relationship between serum cholesterol levels and meta-chlorophenylpiperazine-induced cortisol responses in healthy men and women. Psychiatry Research, 96, 167173.
Virkkunen, M. E., Horrobin, D. F., Jenkins, D. K., et al (1987) Plasma phospholipid essential fatty acids and prostaglandins in alcoholic, habitually violent, and impulsive offenders. Biological Psychiatry, 22, 10871096.
World Health Organization (1993) The ICD-10 Classification of Mental and Behavoiural Disorders: Diagnostic Criteria for Research. WHO.
Yao, J., Stanley, J. A., Reddy, R. D., et al (2002) Correlations between peripheral polyunsaturated fatty acid content and in vivo membrane phospholipid metabolites. Biological Psychiatry, 52, 823830.

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Lipids and essential fatty acids in patients presenting with self-harm

  • Malcolm R. Garland (a1), Brian Hallahan (a1), Mairead McNamara (a2), Philip A. Carney (a1), Helen Grimes (a3), Joseph R. Hibbeln (a4), Andrew Harkin (a2) and Ronan M. Conroy (a5)...
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