Levels of serum total cholesterol and LDL-cholesterol in patients with major depression in acute period and remission.
Jolanta Rabe-Jabłońska, Irena Poprawska
Med Sci Monit 2000; 6(3): CR539-547
The aim of the study was to determine the level of total cholesterol andLDL-cholesterol in blood samples taken from 102 patients with recurrent major depression (according toDSM-IV). The analysis was performed during the acute period of major depression in 3 subgroups: withand without suicidal ideation (S+, S-), and after suicidal attempts (AS), and during remission of depressivesymptoms. Putative correlations between the level of total cholesterol and severity of depressive symptomsand between total serum cholesterol and LDL-cholesterol and suicidal risk were evaluated. The patientsdid not suffer from any additional disorders, factors such as specific diet or pharmacotherapy, whichcould influence the levels of lipids, were absent. The subgroups were identified using clinical evaluation,medical records and Hamilton Depression Rating Scale--HAMD-S as well as a subscale of MMPI-DMS. Biochemicalanalyses were performed twice in all patients, in the acute period, before pharmacotherapy and aftereffective pharmacotherapy, in remission. The following parameters were evaluated: total serum cholesteroland LDL-cholesterol, T3, T4, TSH, ALT, AST, proteinogram. In all depressed patients with acute depressionsymptoms, low levels of total cholesterol and LDL-cholesterol were shown. The level of total cholesterol160 mg/dl or less and the level of LDL-cholesterol 100 mg/dl or less were observed in persons with suicidalbehavior only (S+ and AS). Low total cholesterol and LDL-cholesterol levels in persons in the acute periodof major depression provided a useful parameter of suicide risk. A significant statistical correlationbetween the low level of total cholesterol and suicidal ideation was also found (r = 0.82, p < 0.05)as well as between the low level of serum total cholesterol and severity of depression, as evaluatedby HAMD-S (r = 0.27, p < 0.05). During the remission of depressive symptoms, total cholesterol leveland LDL-cholesterol increased significantly (p < 0.05) but a significant difference (p < 0.05) betweensubgroups (S-, S+, AS) were still observed. Low total cholesterol and LDL-cholesterol levels in remissionin persons with the diagnosis of recurrent major depression may help to estimate the risk of suicidalbehavior in the next depressive disorder. Possibly, low level of serum total cholesterol is a stablefeature in some persons with recurrent major depression, probably dependent on their predisposition toautoaggression and presence of depressive disorder.
Keywords: Blood Proteins, Cholesterol, Depressive Disorder, Female, Humans, Lipoproteins, LDL Cholesterol, MMPI, Male, Psychiatric Status Rating Scales, Recurrence, thyrotropin, thyroxine, Triiodothyronine