ABSTRACT

It has found that serum cholesterol is lowered in cases of depressive-psychosis and other disorders. In many circumstances psychosis often leads to suicidal death. In the present study total serum cholesterol has been estimated in Cases of suicidal death and compared with that of Control. It showed that Cases of suicidal death with history of psychosis register a significantly lower level of serum cholesterol when compared to that of Control.

KEYWORDS:
Total serum cholesterol, Suicidal death, Depressive psychosis, Mental disorders.

INTRODUCTION:

Recent statistics reveal that about 100 persons commit suicide in India daily. The rate of suicidal death is increasing every day due to interplay of multiple factors like psychological, socio-economic, ill health, failures in the examinations, maladjustment in the social and so on. According to a French sociologist Durkeim "Suicide is death resulting directly or indirectly from a positive or negative act of the victim himself which he knows will produce this result". Suicide from existential point of view reflects a behaviour that seeks and finds a solution to an existential problem by making an on the life of the subject. Hence it is a behaviour on the part of the victim which triggers to end his life. There are some biochemical parameters that predict such behaviour which ultimately lead to attempted suicide, deliberate self-harm (Parasuicide) and finally suicide. Some prospective retrospective studies in suicidal victims have pointed out certain biochemical predictors associated with the suicidal behaviour. The present paper attempts to explore the extent of association of one of these predictors in victims of suicidal death.

MATERIALS AND METHODS:
In this study 25 Cases of suicidal having history of psychotic disorders like depressive psychosis, schizophrenia, schizo-affective and personality disorders were chosen and the blood sample was drawn from their heart chambers. The total serum cholesterol estimated in each Case by enzymatic cleavage of cholesterol ester by cholesterol esterase. In all cases the time since death was within six hours to avoid autolysis and decomposition. The collected in these test Cases were arranged in a tabular form taking into account age, sex, method of suicide and average total serum cholesterol. In 30 Control Cases i.e. victims of non-suicidal death chosen randomly, the were collected and worked out similarly fro comparison.
OBSERVATION
TABLE – 1
MEAN SERUM CHOLESTEROL LEVEL IN DIFFERENT AGE GROUPS AND DIFFERENT SEXES IN VICTIMS OF SUICIDAL DEATH (N=25)

AGEW YEARS MALE
MEAN CHOLESTEROL (in mg %) FEMALE
SERUM CHOLESTEROL
15-30 6 141 4 120
31 -45 5 130 4 110
46-60 4 110 1 105
>60 1 100 — —

Cases of suicidal death having history of psychiatric disorders.

TABLE – 2
DIFFERENT METHOD OF SUICIDE AND THEIR MEAN SERUM
CHOLESTEROL LEVEL (N=25)
Method of Suicide Number of Cases Mean Serum Cholesterol
(in mg%)
Railway Track 4 120
Poisoning 12 125
Burning 2 122
Hanging 5 105
Drowning 1 135
Drugs 1 167


TABLE – 3
DIFFERENT PSYCHIATRIC DISORDERS AND THEIR MEAN SERUM
CHOLESTEROL LEVEL (N=25)
Psychiatric Disorders Number of Cases Mean Serum Cholesterol
(in mg%)
Depressive Psychosis 20 135
Schizophrenia 4 140
Personality disorders 1 170

TABLE – 4
CONTROL CASES AND THEIR MEAN SERUM
CHOLESTEROL LEVEL (N=30)
Cause of Death Number of Cases Mean Serum Cholesterol
(in mg%)
Road Accidents 15 170
Homicides 5 165
Other Accidents 7 190
Natural Death 3 200
* Cases other than suicidal death
DISCUSSION

The above tables clearly show that the serum cholesterol is decreased in Cases of suicidal death having history of various mental disorders. Among the suicidal death Cases, the Hanging Cases register comparatively low cholesterol level whereas Cases having history of depressive psychosis register a very low level when compared with that of Cases having other mental disorders. Non suicidal death Cases show more or loss normal level of serum cholesterol whereas Cases of death from natural causes show a moderate increase in the level of serum cholesterol probably due to cardiovascular causes. From various studies, it has been proved that serotonin ( 5 - hydroxyl tryptamine ) - a polypeptide in the brain modifies the mood of a person. Low serotonin is associated with various mental disorders including depressive psychosis. Research studies by Roy, Nuttirk and Linoiia (1988) have shown low serotonin level in C.S.F. of the victims of suicidal death. In another study, brains of suicidal victims reflect a moderately decreased level of serotonin and its metabolite 5 - HIAA i.e. 5 -hydroxyl indole acetic acid (Stenely, Man, Coheir (1988)). Further, serotonin is low in persons having low cholesterol level (BMJ-UCP (M.N.): APR 1996). It is because cholesterol helps in transport of serotonin to the brain (Lawrence, Palinkis,.UCP (M.N.): 1996),
If we correlate the results of the above studies, it is apparently clear that low cholesterol level is often associated with low serotonin level which accounts many a times for the characteristic self-destructing violent behaviour of the victims of suicidal death.

CONCLUSION
While lowering of cholesterol is beneficial to the heart, too low cholesterol level could make a person depressive leading to suicidal death. From the above study it is well understood that low cholesterol level is associated with many instances of suicidal death. Psychiatric patients having low serum-cholesterol level should be carefully observed for development of any suicidal behaviour and timely managed with treatment and life-preserving measures so that many suicides could be avoided.