Suicide and aggression in schizophrenia. Neurobiologic correlates

In this study of schizophrenic patients, we were unable to find an association between past history of suicide attempt and levels of CSF amine metabolites, response to DST, and ventricular size by CT scan, neurobiologic variables each of which have been reported to be associated with attempted suicide in some patient groups. Our data, however, demonstrate the marked responsiveness of measures of aggressive behavior to neuroleptic treatment, suggesting a dopaminergic involvement in these behaviors when observed in the presence of overt psychotic symptoms. Some support for an association between decreased CNS serotonin function and aggressive behavior was found in drug-free schizophrenics, although difficulty in separating illness from trait factors is an important confounding variable. The need for clinical interventions required to treat severely disturbed and aggressive behavior in the schizophrenic patients studied could not be predicted by any of the neurobiologic variables.