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| LETTER TO EDITOR |
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| Year : 2022 | Volume
: 31
| Issue : 2 | Page : 378-379 |
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Low serum lipid levels as predictors of future suicide attempt in Parkinson's disease
Fulvio Alexandre Scorza1, Antonio-Carlos Guimaraes De Almeida2, Carla Alessandra Scorza1, Josef Finsterer3
1 Department of Neurology, Disciplina de Neurociência, EPM/ Federal University of São Paulo; Center for Neuroscience and Women's Health “Professor Geraldo Rodrigues de Lima,” EPM/Federal University of São Paulo, São João del-Rei, Brazil
2 Center for Neuroscience and Women's Health “Professor Geraldo Rodrigues de Lima,” EPM/Federal University of São Paulo; Department of Biosystems Engineering, Laboratory of Experimental and Computational Neuroscience, Federa University of São João del-Rei, São João del-Rei, Brazil
3 Rudolfstiftung Hospital, Messerli Institute, Vienna, Austria
| Date of Submission | 10-Sep-2021 |
| Date of Acceptance | 12-Sep-2021 |
| Date of Web Publication | 02-Aug-2022 |
Correspondence Address:
Prof. Fulvio Alexandre Scorza
Rua Pedro de Toledo, 669-10 Andar, CEP: 04039-032, São Paulo – SP
Brazil
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ipj.ipj_197_21
How to cite this article:
Scorza FA, De Almeida ACG, Scorza CA, Finsterer J. Low serum lipid levels as predictors of future suicide attempt in Parkinson's disease. Ind Psychiatry J 2022;31:378-9 |
Dear Editor,
Depression is the most common condition associated with suicide among elderly individuals.[1] As patients with Parkinson's disease (PD) have many risk factors for suicide,[1] we enjoyed reading the recent article entitled, “Psychiatric morbidity in patients with idiopathic Parkinson's disease: A cross-sectional study” by Kumar et al. published in your esteemed journal.[2] Elegantly, the authors observed that patients with PD have a high prevalence of psychiatric morbidity (mainly depressive disorders) and a significant number of these individuals had suicidality.[2] Following these important clinical findings, we would like to add some thoughts that may open the debate about the possible role of lipids as biological markers of suicide in PD patients.
PD is one of the most frequent age-related neurodegenerative disorders and affects millions of people globally, there is no cure, and several data over the years have shown that PD is not a benign condition since it has a high rate of premature death compared with the general population.[3] The main causes of death for PD patients are pneumonia and cerebrovascular and cardiovascular diseases.[3] In parallel, it is very pertinent to point out that one of the events related to this excess mortality but infrequently mentioned is suicide.[1] Really, although there are clear indications that the number of suicides is highest among older adults in almost all regions of the world, this remains an area in need of study in PD.[1] Looking through this prism, findings from several studies have shown that suicidal ideation is common in PD.[1],[2] Importantly, although there is little consensus on the association between suicide and PD, several studies have demonstrated high suicide rates in PD patients.[1],[4] Obviously, patients with PD have many risk factors for suicide.[1],[2] However, as approximately 40%–50% of patients with PD are affected by depression,[4] the risk of death by suicide in PD may, in part, be related to the severity of the depression.[1],[4] With these considerations in mind, we are also convinced that future studies should explore factors to better understand the high suicide risk in PD.[4] In these terms, many researchers have attempted to identify biological markers that could be linked to suicidal behavior.[1] These studies suggest that lipid changes may be related to suicidality.[5] One possible explanation is that low cholesterol levels result in decreased brain serotonin availability, the neurochemical system that suppresses aggressive or socially inappropriate behaviors.[5] Another explanation could be that decreased blood levels of cholesterol are correlated with symptoms of depression, a significant suicide risk factor.[5]
On the whole, where do we go from here? First, it becomes clear that lipid levels can be low in PD. Second, our research group fully agrees that further studies are needed to explore whether low lipid values may be associated with a higher risk of suicide attempts, including in PD patients. Considering all these insights, it is imaginable that low cholesterol levels mediate biological mechanisms which increase the risk of suicide in PD patients.
Acknowledgments
Our studies are supported by the following grants: FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo), CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico), CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), and FAPEMIG (Fundação de Amparo à Pesquisa do Estado de Minas Gerais).
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 References | |  |
| 1. | Shepard MD, Perepezko K, Broen MP, Hinkle JT, Butala A, Mills KA, et al. Suicide in Parkinson's disease. J Neurol Neurosurg Psychiatry 2019;90:822-9.  |
| 2. | Kumar S, Avasthi A, Modi M, Grover S. Psychiatric morbidity in patients with idiopathic Parkinson's disease: A cross-sectional study. Ind Psychiatry J 2021;30:165-74. [Full text] |
| 3. | Scorza FA, Fiorini AC, Scorza CA, Finsterer J. Cardiac abnormalities in Parkinson's disease and Parkinsonism. J Clin Neurosci 2028;53:1-5. |
| 4. | Chen YY, Yu S, Hu YH, Li CY, Artaud F, Carcaillon-Bentata L, et al. Risk of suicide among patients with Parkinson disease. JAMA Psychiatry 2021;78:293-301. |
| 5. | Kułak-Bejda A, Bejda G, Lech M, Waszkiewicz N. Are lipids possible markers of suicide behaviors? J Clin Med 2021;10:333. |
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