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

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.