{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:46:45Z","timestamp":1792464405597,"version":"4.5.0"},"reference-count":73,"publisher":"Wiley","issue":"5p2","license":[{"start":{"date-parts":[[2006,10,17]],"date-time":"2006-10-17T00:00:00Z","timestamp":1161043200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2006,10]]},"abstract":"<jats:p><jats:bold>Objectives:\u2002<\/jats:bold> Bipolar disorder is a severe illness that is associated with suicidal behavior. A biological predictor of highly lethal suicide attempts in patients with bipolar disorder would be valuable. We hypothesized that cerebrospinal fluid (CSF) monoamine metabolite levels are related to lethality of suicide attempts in bipolar patients and examined the relation between CSF 5\u2010hydroxyindolacetic acid (5\u2010HIAA), homovanillic acid (HVA), and 3\u2010methoxy\u20104\u2010hydroxyphenylglycol (MHPG) levels and maximum lethality of suicide attempts at baseline and during a 2\u2010year follow up.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> Twenty\u2010seven bipolar depressed patients participated in the study. Demographic and clinical parameters were examined and recorded. Lumbar punctures were performed and CSF 5\u2010HIAA, HVA, and MHPG were assayed by high\u2010performance liquid chromatography with electrochemical detection. Following discharge, patients were evaluated after 3\u2003months, 1\u2003year, and 2\u2003years. Each follow\u2010up interview included an in\u2010depth assessment of suicidal behavior during the intervening time period.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Six subjects made suicide attempts during the 2\u2010year follow\u2010up. Bipolar patients who attempted suicide during the follow\u2010up period had higher aggression and hostility scale scores compared to bipolar subjects who did not make a suicide attempt during the follow\u2010up period. CSF 5\u2010HIAA, HVA, and MHPG levels were negatively correlated with the maximum lethality of suicide attempts during the 2\u2010year follow\u2010up period.<\/jats:p><jats:p><jats:bold>Conclusions:\u2002<\/jats:bold> Our finding is the first observation that CSF monoamine metabolite levels may be predictors of lethality of suicide attempts in patients with bipolar disorder. Further studies are necessary to answer the question whether CSF monoamine metabolite levels are clinically useful biochemical predictors of highly lethal suicide attempts or completed suicides.<\/jats:p>","DOI":"10.1111\/j.1399-5618.2006.00319.x","type":"journal-article","created":{"date-parts":[[2006,10,18]],"date-time":"2006-10-18T16:06:57Z","timestamp":1161187617000},"page":"543-550","source":"Crossref","is-referenced-by-count":56,"title":["A prospective study of the association of cerebrospinal fluid monoamine metabolite levels with lethality of suicide attempts in patients with bipolar disorder"],"prefix":"10.1111","volume":"8","author":[{"given":"Leo","family":"Sher","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan J","family":"Carballo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael 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