Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Cholesterol and Violent Behavior

Cholesterol and Violent Behavior Abstract Despite significant increases in the incidence of myocardial infarction, reduction of total mortality as a result of cholesterol-lowering programs has not been demonstrated. This puzzling outcome has led to several hypotheses linking cholesterol levels and mortality due to accidents, suicide, and homicide. We review the proposed explanations for increased mortality due to violent deaths. We discuss the available evidence and conclude that while there are some intriguing findings based on the well-established relationship between violent behavior and serotonin activity, the necessary link between cholesterol, serotonin, and violence has not been demonstrated. The complexity of the observed violent behaviors and their multiple determinants defies a simple explanation at the present time. (Arch Intern Med. 1994;154:1317-1321) References 1. Consensus Conference. Lowering blood cholesterol to prevent heart disease . JAMA . 1985;253: 2080-2086.Crossref 2. National Cholesterol Education Program Expert Panel. Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults . Arch Intern Med. 1988;148:36-69.Crossref 3. NIH Consensus Development Panel on Triglyceride, High-Density Lipoprotein, and Coronary Heart Disease. Triglyceride, high-density lipoprotein, and coronary heart disease . JAMA . 1993;269:505-510.Crossref 4. Lipid Research Clinics Program. The Lipid Research Clinics Coronary Primary Prevention Trials results, I: reduction in the incidence of coronary heart disease . JAMA . 1984;251:351-364.Crossref 5. Frick MH, Elo O, Haapa K, et al. Helsinki Heart Study: primary prevention trials with gemfibrozil in middle-aged men with dyslipedemia . N Engl J Med. 1987;317:1237-1245.Crossref 6. Buchwald H, Varco RI, Matts JP, et al. Effects of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia . N Engl J Med. 1990;323:946-955.Crossref 7. Arntzenius AC, Kromhout D, Barth JD, et al. Diet, lipoproteins, and the progressions of coronary atherosclerosis: the Leiden Intervention Trial . N Engl J Med. 1985;312:805-811.Crossref 8. Blankenhorn DH, Nessim SA, Johnson RL, Sanmarco ME, Azen SP, Cashin-Hemphill L. Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts . JAMA . 1987;257:3233-3240.Crossref 9. Oliver MF. Reducing cholesterol does not reduce mortality . J Am Coll Cardiol. 1988;12:814-817. 10. Jacobs D, Blackburn H, Higgins M, et al. Report on the Conference on Low Blood Cholesterol: mortality associations . Circulation . 1992;86:1046-1060.Crossref 11. Hulley SB, Walsh JBM, Newman TB. Health policy on blood cholesterol: time to change directions . Circulation. 1992;86:1026-1029.Crossref 12. Holme I. An analysis of randomized trials evaluating the effects of cholesterol reduction on total mortality and CHD incidence . Circulation. 1990; 82:1916-1924.Crossref 13. Rossouw JE, Canner PO, Hulley SB. Deaths from injury, violence, and suicide in secondary prevention trials of cholesterol lowering . N Engl J Med. 1991;325:1813. 14. Ravnskov V. Cholesterol lowering trials in coronary heart disease: frequency of and outcome . BMJ . 1992;305:15-19.Crossref 15. Smith GD, Pekkanen J. Should there be a moratorium on the use of cholesterol lowering drugs? BMJ . 1992;304:431-434.Crossref 16. The Multiple Risk Factor Intervention Trial Research Group. Mortality rates after 10.5 years for participants in the Multiple Risk Factor Intervention Trial: findings related to a priori hypotheses of the trial . JAMA . 1990;263:1795-1801.Crossref 17. Neaton JD, Blackburn H, Jacobs D, the Multiple Risk Factor Intervention Trial Research Group. Serum cholesterol level and mortality findings for men screened in the Multiple Risk Factor Intervention Trial . Arch Intern Med. 1992;152:1490-1500.Crossref 18. Strandberg TE, Salomaa W, Naukkarinen VA, Vanhanen HT, Sarna SJ, Miettinen TA. Long-term mortality after 5-year multifactorial primary prevention of cardiovascular diseases in middle-aged men . JAMA . 1991;266:1225-1229.Crossref 19. Hjermann I, Velve Byre K, Holme I, Leren P. Effect of diet and smoking intervention on the incidence of coronary heart disease: report from the Oslo Study Group of a randomized trial in healthy men . Lancet. 1981;2:1303-1310.Crossref 20. Multiple Risk Factor Intervention Trial Research Group. Coronary heart disease death, nonfatal acute myocardial infarction and other clinical outcomes in the Multiple Risk Factor Intervention Trial . Am J Cardiol. 1986;58:1-13.Crossref 21. World Health Organization European Collaborative Group. European Collaborative Trial of Multifactorial Prevention of Coronary Heart Disease: final report on the 6-year result . Lancet . 1986;1:869-872. 22. Smith GD, Shipley MJ, Marmot MG, Rose G. Plasma cholesterol concentration and mortality: the Whitehall Study . JAMA . 1992;267:70-76.Crossref 23. Virkkunen M. Lipid Research Clinics Primary Prevention Trial results . JAMA . 1985;253:635-636.Crossref 24. Muldoon MF, Manuck SB, Matthews KA. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials . BMJ . 1990;301:309-314.Crossref 25. Muldoon M, Manuck SB, Matthews KA. Does cholesterol lowering increase non—illness-related mortality? Arch Intern Med. 1991;151:1453.Crossref 26. Pekkanen J, Nissinen A, Punsar S, Karvonen MJ. Serum cholesterol and risk of accidental or violent death in a 25-year follow-up: Finnish cohorts of the Seven Countries Study . Arch Intern Med. 1989;149:1589-1591.Crossref 27. Wysowski DK, Gross TP. Deaths due to accidents and violence in two recent trials of cholesterol-lowering drugs . Arch Intern Med. 1990; 150:2169-2172.Crossref 28. Kaplan J, Manuck S, Shively C. The effects of fat and cholesterol on social behavior in monkeys . Psychosom Med. 1991;53:634-642.Crossref 29. Yehuda S, Leprohon-Greenwood CE, Dixon LM, Coscina DV. Effects of dietary fat on pain threshold, thermoregulation and motor activity in rats . Pharmacol Biochem Behav. 1986;24:1775-1777.Crossref 30. Virkkunen M. Serum cholesterol in antisocial personality . Neuropsychobiology . 1983;10:65-69.Crossref 31. Virkkunen M, Penittinen H. Serum cholesterol in aggressive conduct disorder: a preliminary study . Biol Psychiatry. 1984;19:435-439. 32. Coccaro EF, Siever LJ, Klar HM, et al. Serotonergic studies in patients with affective and personality disorders: correlates with suicidal and impulsive aggressive behavior . Arch Gen Psychiatry . 1989;46:587-599.Crossref 33. Virkkunen M, DeJong J, Bartko J, Goodwin FK, Linnoila M. Relationship of psychobiological variables to recidivism in violent offenders and impulsive fire setters: a follow-up study . Arch Gen Psychiatry. 1989;46:600-603.Crossref 34. Virkkunen M, DeJong J, Bartko J, Linnoila M. Psychobiological concomitants of history of suicide attempts among violent offenders and impulsive fire setters . Arch Gen Psychiatry. 1989;46:604-606.Crossref 35. Roy A, DeJong J, Linnoila M. Cerebrospinal fluid monoamine metabolites and suicidal behavior in depressed patients: a 5-year follow-up study . Arch Gen Psychiatry. 1989;46:609-612.Crossref 36. Muldoon MF, Kaplan JR, Manuck SB, Mann JJ. Effect of a low-fat diet on brain serotonergic response in cynomolgus monkeys . Biol Psychiatry. 1992;31:739-742.Crossref 37. Cooper SJ, Kelly CB, King DJ. 5-Hydroxyindole acetic acid in cerebrospinal fluid and prediction of suicidal behavior in schizophrenia . Lancet . 1992; 340:940-941.Crossref 38. Gelenberg A. A serotonin agonist against aggression . Biol Ther Psychiatry Newslett. (May) 1993; 16:18-19. 39. Virkkunen M. Serum cholesterol levels in homicidal offenders . Neuropsychobiology . 1983;10: 65-69.Crossref 40. Swartz CM. Albumin decrement in depression and cholesterol decrement in mania . J Affect Disord. 1990;19:173-176.Crossref 41. Rao U, Carlson GA, Rapport MD. Serum cholesterol and aggressive behavior in psychiatrically hospitalized children . Acta Psychiatr Scand. 1991;83:77-78.Crossref 42. Hayward C, Taylor CB, Roth WT. Plasma lipid levels in patients with panic disorder or agoraphobia . Am J Psychiatry. 1989;146:917-919. 43. Bajwa WK, Asnis GM, Sanderson WC, et al. High cholesterol levels in patients with panic disorder . Am J Psychiatry. 1992;149:376-378. 44. Rudd DM, Dahm PF, Rajab MH. Diagnostic co-morbidity in persons with suicidal ideation and behavior . Am J Psychiatry . 1993;150:6:928-934. 45. Weidmer G, Connor SL, Hollis JF, Connor WE. Improvements in hostility and depression in relation to dietary change and cholesterol lowering: the Family Heart Study . Ann Intern Med. 1992; 117:820-823.Crossref 46. Kivelä SL. Relationship between suicide, homicide and accidental deaths among the aged in Finland in 1951-1979 . Acta Psychiatr Scand. 1985; 72:155-160.Crossref 47. Suarez EC, Williams RB Jr, Kuhn CM, et al. Biobehavioral basis of coronary-prone behavior in middle-aged men, II: serum cholesterol, the type A behavior pattern, and hostility as interactive modulators of physiological reactivity . Psychosom Med. 1991;53:528-537.Crossref 48. Smith GD, Shipley MJ. Lowering cholesterol concentrations and mortality . BMJ . 1990;301:552. 49. Barradas MA, Mikhailiois DP, Winder AF. Low serum cholesterol and suicide . Lancet . 1992; 339:1168.Crossref 50. Engelberg H. Low serum cholesterol and suicide . Lancet . 1992;339:727-729.Crossref 51. Preston R, Mason L, Herbette G, Silverman DI. Can alternating serum cholesterol affect neurologic function? J Mol Cell Cardiol. 1991;23:1339-1342.Crossref 52. Severs NJ. Low serum cholesterol and suicide . Lancet. 1992;339:1001.Crossref 53. Risch SC, Nemeroff CB. Neurochemical alterations of serotonergic systems in depression . J Clin Psychiatry. 1992;53( (October suppl) ):3-7. 54. Den Boer JA, Westenberg HGM. Behavioral, neuroendocrine and biochemical effects of 5-HTP administration in panic disorders . Psychiatr Res. 1990;31:267-278.Crossref 55. Lawlor BA, Sunderland T, Mellow AM, Hill JL, Molchen SE, Murphy DL. Hyperresponsivity to the serotonin agonist m-chlorophenylpiperazine in Alzheimer's disease: a controlled study . Arch Gen Psychiatry. 1989;46:542-549.Crossref 56. Coccaro EF, Astill JL, Szeeley PJ, et al. Serotonin in personality disorders . Psychiatry Ann. 1990; 20:587-592.Crossref 57. Coccaro EF. Central serotonin and impulsive aggression . Br J Psychiatry. 1989;155( (suppl 8) ): 52-62. 58. Linnoila VMI, Virkkunen M. Aggression, suicidality and serotonin . J Clin Psychiatry. 1992;53: ( (October suppl) ):46-51. 59. Kety S. Genetic factors in suicide . In: Roy A, ed. Suicide . Baltimore, Md: Williams & Wilkins; 1986: 41-45. 60. Roy A, DeJong J, Linnoila M. Cerebrospinal fluid monamine metabolites and suicidal behavior in depressed patients . Arch Gen Psychiatry . 1989; 46:609-612.Crossref 61. Henriksson MM, Aro HM, Marttunen MJ, et al. Mental disorders and comorbidity in suicide . Am J Psychiatry. 1993;150:935-940. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Cholesterol and Violent Behavior

Loading next page...
 
/lp/american-medical-association/cholesterol-and-violent-behavior-ihKYrUzeRb
Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1994.00420120025003
Publisher site
See Article on Publisher Site

Abstract

Abstract Despite significant increases in the incidence of myocardial infarction, reduction of total mortality as a result of cholesterol-lowering programs has not been demonstrated. This puzzling outcome has led to several hypotheses linking cholesterol levels and mortality due to accidents, suicide, and homicide. We review the proposed explanations for increased mortality due to violent deaths. We discuss the available evidence and conclude that while there are some intriguing findings based on the well-established relationship between violent behavior and serotonin activity, the necessary link between cholesterol, serotonin, and violence has not been demonstrated. The complexity of the observed violent behaviors and their multiple determinants defies a simple explanation at the present time. (Arch Intern Med. 1994;154:1317-1321) References 1. Consensus Conference. Lowering blood cholesterol to prevent heart disease . JAMA . 1985;253: 2080-2086.Crossref 2. National Cholesterol Education Program Expert Panel. Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults . Arch Intern Med. 1988;148:36-69.Crossref 3. NIH Consensus Development Panel on Triglyceride, High-Density Lipoprotein, and Coronary Heart Disease. Triglyceride, high-density lipoprotein, and coronary heart disease . JAMA . 1993;269:505-510.Crossref 4. Lipid Research Clinics Program. The Lipid Research Clinics Coronary Primary Prevention Trials results, I: reduction in the incidence of coronary heart disease . JAMA . 1984;251:351-364.Crossref 5. Frick MH, Elo O, Haapa K, et al. Helsinki Heart Study: primary prevention trials with gemfibrozil in middle-aged men with dyslipedemia . N Engl J Med. 1987;317:1237-1245.Crossref 6. Buchwald H, Varco RI, Matts JP, et al. Effects of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia . N Engl J Med. 1990;323:946-955.Crossref 7. Arntzenius AC, Kromhout D, Barth JD, et al. Diet, lipoproteins, and the progressions of coronary atherosclerosis: the Leiden Intervention Trial . N Engl J Med. 1985;312:805-811.Crossref 8. Blankenhorn DH, Nessim SA, Johnson RL, Sanmarco ME, Azen SP, Cashin-Hemphill L. Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts . JAMA . 1987;257:3233-3240.Crossref 9. Oliver MF. Reducing cholesterol does not reduce mortality . J Am Coll Cardiol. 1988;12:814-817. 10. Jacobs D, Blackburn H, Higgins M, et al. Report on the Conference on Low Blood Cholesterol: mortality associations . Circulation . 1992;86:1046-1060.Crossref 11. Hulley SB, Walsh JBM, Newman TB. Health policy on blood cholesterol: time to change directions . Circulation. 1992;86:1026-1029.Crossref 12. Holme I. An analysis of randomized trials evaluating the effects of cholesterol reduction on total mortality and CHD incidence . Circulation. 1990; 82:1916-1924.Crossref 13. Rossouw JE, Canner PO, Hulley SB. Deaths from injury, violence, and suicide in secondary prevention trials of cholesterol lowering . N Engl J Med. 1991;325:1813. 14. Ravnskov V. Cholesterol lowering trials in coronary heart disease: frequency of and outcome . BMJ . 1992;305:15-19.Crossref 15. Smith GD, Pekkanen J. Should there be a moratorium on the use of cholesterol lowering drugs? BMJ . 1992;304:431-434.Crossref 16. The Multiple Risk Factor Intervention Trial Research Group. Mortality rates after 10.5 years for participants in the Multiple Risk Factor Intervention Trial: findings related to a priori hypotheses of the trial . JAMA . 1990;263:1795-1801.Crossref 17. Neaton JD, Blackburn H, Jacobs D, the Multiple Risk Factor Intervention Trial Research Group. Serum cholesterol level and mortality findings for men screened in the Multiple Risk Factor Intervention Trial . Arch Intern Med. 1992;152:1490-1500.Crossref 18. Strandberg TE, Salomaa W, Naukkarinen VA, Vanhanen HT, Sarna SJ, Miettinen TA. Long-term mortality after 5-year multifactorial primary prevention of cardiovascular diseases in middle-aged men . JAMA . 1991;266:1225-1229.Crossref 19. Hjermann I, Velve Byre K, Holme I, Leren P. Effect of diet and smoking intervention on the incidence of coronary heart disease: report from the Oslo Study Group of a randomized trial in healthy men . Lancet. 1981;2:1303-1310.Crossref 20. Multiple Risk Factor Intervention Trial Research Group. Coronary heart disease death, nonfatal acute myocardial infarction and other clinical outcomes in the Multiple Risk Factor Intervention Trial . Am J Cardiol. 1986;58:1-13.Crossref 21. World Health Organization European Collaborative Group. European Collaborative Trial of Multifactorial Prevention of Coronary Heart Disease: final report on the 6-year result . Lancet . 1986;1:869-872. 22. Smith GD, Shipley MJ, Marmot MG, Rose G. Plasma cholesterol concentration and mortality: the Whitehall Study . JAMA . 1992;267:70-76.Crossref 23. Virkkunen M. Lipid Research Clinics Primary Prevention Trial results . JAMA . 1985;253:635-636.Crossref 24. Muldoon MF, Manuck SB, Matthews KA. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials . BMJ . 1990;301:309-314.Crossref 25. Muldoon M, Manuck SB, Matthews KA. Does cholesterol lowering increase non—illness-related mortality? Arch Intern Med. 1991;151:1453.Crossref 26. Pekkanen J, Nissinen A, Punsar S, Karvonen MJ. Serum cholesterol and risk of accidental or violent death in a 25-year follow-up: Finnish cohorts of the Seven Countries Study . Arch Intern Med. 1989;149:1589-1591.Crossref 27. Wysowski DK, Gross TP. Deaths due to accidents and violence in two recent trials of cholesterol-lowering drugs . Arch Intern Med. 1990; 150:2169-2172.Crossref 28. Kaplan J, Manuck S, Shively C. The effects of fat and cholesterol on social behavior in monkeys . Psychosom Med. 1991;53:634-642.Crossref 29. Yehuda S, Leprohon-Greenwood CE, Dixon LM, Coscina DV. Effects of dietary fat on pain threshold, thermoregulation and motor activity in rats . Pharmacol Biochem Behav. 1986;24:1775-1777.Crossref 30. Virkkunen M. Serum cholesterol in antisocial personality . Neuropsychobiology . 1983;10:65-69.Crossref 31. Virkkunen M, Penittinen H. Serum cholesterol in aggressive conduct disorder: a preliminary study . Biol Psychiatry. 1984;19:435-439. 32. Coccaro EF, Siever LJ, Klar HM, et al. Serotonergic studies in patients with affective and personality disorders: correlates with suicidal and impulsive aggressive behavior . Arch Gen Psychiatry . 1989;46:587-599.Crossref 33. Virkkunen M, DeJong J, Bartko J, Goodwin FK, Linnoila M. Relationship of psychobiological variables to recidivism in violent offenders and impulsive fire setters: a follow-up study . Arch Gen Psychiatry. 1989;46:600-603.Crossref 34. Virkkunen M, DeJong J, Bartko J, Linnoila M. Psychobiological concomitants of history of suicide attempts among violent offenders and impulsive fire setters . Arch Gen Psychiatry. 1989;46:604-606.Crossref 35. Roy A, DeJong J, Linnoila M. Cerebrospinal fluid monoamine metabolites and suicidal behavior in depressed patients: a 5-year follow-up study . Arch Gen Psychiatry. 1989;46:609-612.Crossref 36. Muldoon MF, Kaplan JR, Manuck SB, Mann JJ. Effect of a low-fat diet on brain serotonergic response in cynomolgus monkeys . Biol Psychiatry. 1992;31:739-742.Crossref 37. Cooper SJ, Kelly CB, King DJ. 5-Hydroxyindole acetic acid in cerebrospinal fluid and prediction of suicidal behavior in schizophrenia . Lancet . 1992; 340:940-941.Crossref 38. Gelenberg A. A serotonin agonist against aggression . Biol Ther Psychiatry Newslett. (May) 1993; 16:18-19. 39. Virkkunen M. Serum cholesterol levels in homicidal offenders . Neuropsychobiology . 1983;10: 65-69.Crossref 40. Swartz CM. Albumin decrement in depression and cholesterol decrement in mania . J Affect Disord. 1990;19:173-176.Crossref 41. Rao U, Carlson GA, Rapport MD. Serum cholesterol and aggressive behavior in psychiatrically hospitalized children . Acta Psychiatr Scand. 1991;83:77-78.Crossref 42. Hayward C, Taylor CB, Roth WT. Plasma lipid levels in patients with panic disorder or agoraphobia . Am J Psychiatry. 1989;146:917-919. 43. Bajwa WK, Asnis GM, Sanderson WC, et al. High cholesterol levels in patients with panic disorder . Am J Psychiatry. 1992;149:376-378. 44. Rudd DM, Dahm PF, Rajab MH. Diagnostic co-morbidity in persons with suicidal ideation and behavior . Am J Psychiatry . 1993;150:6:928-934. 45. Weidmer G, Connor SL, Hollis JF, Connor WE. Improvements in hostility and depression in relation to dietary change and cholesterol lowering: the Family Heart Study . Ann Intern Med. 1992; 117:820-823.Crossref 46. Kivelä SL. Relationship between suicide, homicide and accidental deaths among the aged in Finland in 1951-1979 . Acta Psychiatr Scand. 1985; 72:155-160.Crossref 47. Suarez EC, Williams RB Jr, Kuhn CM, et al. Biobehavioral basis of coronary-prone behavior in middle-aged men, II: serum cholesterol, the type A behavior pattern, and hostility as interactive modulators of physiological reactivity . Psychosom Med. 1991;53:528-537.Crossref 48. Smith GD, Shipley MJ. Lowering cholesterol concentrations and mortality . BMJ . 1990;301:552. 49. Barradas MA, Mikhailiois DP, Winder AF. Low serum cholesterol and suicide . Lancet . 1992; 339:1168.Crossref 50. Engelberg H. Low serum cholesterol and suicide . Lancet . 1992;339:727-729.Crossref 51. Preston R, Mason L, Herbette G, Silverman DI. Can alternating serum cholesterol affect neurologic function? J Mol Cell Cardiol. 1991;23:1339-1342.Crossref 52. Severs NJ. Low serum cholesterol and suicide . Lancet. 1992;339:1001.Crossref 53. Risch SC, Nemeroff CB. Neurochemical alterations of serotonergic systems in depression . J Clin Psychiatry. 1992;53( (October suppl) ):3-7. 54. Den Boer JA, Westenberg HGM. Behavioral, neuroendocrine and biochemical effects of 5-HTP administration in panic disorders . Psychiatr Res. 1990;31:267-278.Crossref 55. Lawlor BA, Sunderland T, Mellow AM, Hill JL, Molchen SE, Murphy DL. Hyperresponsivity to the serotonin agonist m-chlorophenylpiperazine in Alzheimer's disease: a controlled study . Arch Gen Psychiatry. 1989;46:542-549.Crossref 56. Coccaro EF, Astill JL, Szeeley PJ, et al. Serotonin in personality disorders . Psychiatry Ann. 1990; 20:587-592.Crossref 57. Coccaro EF. Central serotonin and impulsive aggression . Br J Psychiatry. 1989;155( (suppl 8) ): 52-62. 58. Linnoila VMI, Virkkunen M. Aggression, suicidality and serotonin . J Clin Psychiatry. 1992;53: ( (October suppl) ):46-51. 59. Kety S. Genetic factors in suicide . In: Roy A, ed. Suicide . Baltimore, Md: Williams & Wilkins; 1986: 41-45. 60. Roy A, DeJong J, Linnoila M. Cerebrospinal fluid monamine metabolites and suicidal behavior in depressed patients . Arch Gen Psychiatry . 1989; 46:609-612.Crossref 61. Henriksson MM, Aro HM, Marttunen MJ, et al. Mental disorders and comorbidity in suicide . Am J Psychiatry. 1993;150:935-940.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 27, 1994

References