The British Journal of Psychiatry (2007) 190: 112-117. doi: 10.1192/bjp.bp.105.019562
© 2007 The Royal College of Psychiatrists
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Lipids and essential fatty acids in patients presenting with self-harm{dagger}

MALCOLM R. GARLAND, MD, MRCPsych, MRCPI and BRIAN HALLAHAN, MD, MRCPsych

Department of Adult Psychiatry, Galway University Hospital and the Clinical Sciences Institute, National University of Ireland, Galway

MAIREAD McNAMARA, PhD

Department of Experimental Pharmacology, National University of Ireland, Galway

PHILIP A. CARNEY, FRCPsych

Department of Adult Psychiatry, Galway University Hospital and the Clinical Sciences Institute, National University of Ireland, Galway

HELEN GRIMES, PhD

Department of Clinical Biochemistry, Galway University Hospital

JOSEPH R. HIBBELN, MD

Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland, USA

ANDREW HARKIN, PhD

Department of Experimental Pharmacology, National University of Ireland, Galway

RONAN M. CONROY, DSc

Department of Epidemiology and Biostatistics, The Royal College of Surgeons in Ireland, Dublin, Ireland.

Correspondence: Dr Malcolm R. Garland, St Ita’s Hospital, Portrane, County Dublin, Ireland. Email: mgarland{at}ireland.com

Declaration of interest None

{dagger} See pp. 118–122, this issue.

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 (4.18 (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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