{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T20:23:51Z","timestamp":1778099031999,"version":"3.51.4"},"reference-count":75,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T00:00:00Z","timestamp":1594944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Low total cholesterol has been linked with adverse mental symptoms such as aggression and impulsivity in severe mental disorders (SMDs). This putative association may affect the clinician's decision making about cholesterol lowering in this patient group. Here, we investigated the associations between cholesterol levels, aggression, and impulsivity in a large representative sample of in\u2010 and outpatients with SMD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with schizophrenia\u2010 or bipolar spectrum disorders (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a01\u00a0001) underwent thorough clinical characterization and blood sampling (total cholesterol, low\u2010density lipoprotein cholesterol, high\u2010density lipoprotein cholesterol). Aggression was characterized by the Positive and Negative Syndrome Scale Excited Component. Impulsivity was measured with the Barratt Impulsiveness Scale in a subsample of patients (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a0288). We used a multinomial logistic regression model to analyze the association between cholesterol and aggression and a multiple linear regression model to analyze the association between cholesterol and impulsivity, while controlling for confounders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found no significant associations between cholesterol levels and aggression or impulsivity. There were no significant interactions between cholesterol and diagnostic group or inpatient versus outpatient status. Controlling for medication use, body mass index, alcohol or illicit substance use did not affect the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large sample of patients with schizophrenia\u2010 and bipolar spectrum disorders, we found no associations between cholesterol levels and aggression or impulsivity. This has clinical implications as patients with SMD are at increased CVD risk and currently undertreated with statins.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.1751","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T22:29:20Z","timestamp":1595024960000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Disentangling the relationship between cholesterol, aggression, and impulsivity in severe mental disorders"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1257-6731","authenticated-orcid":false,"given":"Gabriela","family":"Hjell","sequence":"first","affiliation":[{"name":"NORMENT Division of Mental Health and Addiction Oslo University Hospital &amp; Institute of Clinical Medicine University of Oslo Oslo Norway"},{"name":"Departments of Psychiatry and Clinical Research Ostfold Hospital Gralum Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn","family":"M\u00f8rch\u2010Johnsen","sequence":"additional","affiliation":[{"name":"NORMENT Division of Mental Health and Addiction Oslo University Hospital &amp; 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