People with the eating disorder anorexia nervosa are more likely to attempt suicide if their cholesterol levels are low, new research suggests.

For several years, numerous studies have identified a link between low cholesterol and risk of suicide. However, it’s far from clear if there’s a cause and effect.

Conceivably, low cholesterol might lower brain chemicals that affect mood, but on the other hand depression might cause a drop in cholesterol.

Or, perhaps a third irregularity results in a drop in both cholesterol and mood-related hormones.

In the current study, in the journal Psychosomatic Medicine, Dr. Paolo Santonastaso, of the University of Padua, Italy, and colleagues assessed cholesterol levels and nutritional status in 74 patients with anorexia nervosa before they started to eat again. All subjects completed a structured interview that evaluated suicidal thoughts and behaviors.

Subjects who reported previous suicide attempts, impulsive self-injurious behavior, or current suicidal thoughts had lower cholesterol levels than those who did not report thinking about or attempting suicide.

The cholesterol-suicide link held true for patients with the restrictive type of anorexia, in which food intake is limited, as well as for those with the binge eating/purging type. Moreover, the association was not influenced by nutritional status or metabolic factors.

The authors also found that except in patients with recurrent binge eating, depressive symptoms became less severe as cholesterol levels rose.

“Although our findings need to be considered cautiously, they nevertheless highlight the need to gain a better understanding of the relationship between dietary lipids and psychopathology,” Santonastaso and colleagues conclude.

SOURCE: Psychosomatic Medicine, July/August 2004.