Clinical characteristics and biological parameters in temperamental clusters of suicide attempters

A sample of 215 suicide attempters was categorized in a cluster analysis into four groups according to temperamental traits. Monoamine metabolites in the cerebrospinal fluid were analysed (n = 106). Dexamethasone suppression tests (DST) were performed (n = 154) and the activity of the enzyme monoamine oxidase in platelets (pl-MAO) was assessed (n = 103). Patients belonging to the two clusters with the most deviant temperament profiles (nos 2 and 3) were young and scored high on the Beck Hopelessness Scale and the Suicide Assessment Scale. ''Cluster 3'' (''neurotic, impulsive, aggressive'') patients often had dysthymia and axis II, cluster B diagnoses (e.g. borderline or histrionic personality). ''Cluster 2'' (''neurotic and introverted'') patients often had major depression. The ''Cluster 1'', with on the whole a normal temperament profile, had significantly higher levels of post-DST cortisol than the other clusters. The ''Cluster 4'' had a normal temperament profile. Adjustment disorders were most common in ''Cluster 1'' and ''Cluster 4''. The monoamine metabolite levels did not differ between the clusters, and the differences in pl-MAO activity disappeared after adjusting for age and gender, The results suggest that temperament profiles in suicide attempters are related to psychiatric diagnoses, suicidality, hopelessness, and post-DST cortisol, but are not predictive of completed suicide. (C) 1997 Elsevier Science B.V.