Editorials

Cholesterol, violent death, and mental disorder

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6952.421 (Published 13 August 1994) Cite this as: BMJ 1994;309:421
  1. A Ryman

    Although primary prevention studies have shown that reducing serum cholesterol concentration leads to a clear reduction in cardiac morbidity and mortality, total mortality is unaffected. The increase in deaths from accidents, violence, and suicide in the treated groups has not yet been adequately explained,1 though an association between low cholesterol concentration and psychiatric illness has been suggested as a possible cause.2 The finding has also been elaborated in neurobiological terms, implicating a relation between membrane cholesterol, serotonin, and impulsivity.3

    How seriously should this association be taken? Is the apparent relation of suicidal, accidental, and violent death with low serum cholesterol concentrations a true finding or simply due to chance? The association was initially regarded as an anomalous occurrence, but it has been too consistent to be dismissed.4 It has appeared in studies …

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