The Marke-Nyman Temperament (MNT) scale in relationship with monoamine metabolism and corticosteroid measures in suicide attempters

Various monoaminergic measures as well as corticosteroid deviances have repeatedly been linked to depression or suicidal behavior. With the purpose to study these biological markers in relationship with temperament, the Marke-Nyman Temperament (MNT) questionnaire was administered in a sample of 89 suicide attempters, The subjects were diagnosed according to the DSM-III-R and subgrouped according to suicide method into ''violent'' and ''nonviolent'' attempters, and into ''repeaters'' (with previous attempt) and ''nonrepeaters'' (without previous attempts), The subjects were also subgrouped according to MNT patterns into 5 MNT clusters, Lumbar punctures were performed and the monoamine metabolites homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA) and 3-methoxy-4-hydroxyphenylglycole (MHPG) in the cerebrospinal fluid (CSF) were analysed. The levels of plasma cortisol and 24h, urinary cortisol were determined and dexamethasone suppression tests (DST) were performed. The activity of the enzyme monoamine oxidase (MAO) in platelets was determined. Among the alcoholic patients, the biological markers showed several specific correlations with temperament. In this group, low Solidity (reflecting impulsiveness) was significantly associated with low levels of CSF KVA, CSF 5-HIAA, urinary cortisol and low platelet MAO activity. The Stability (reflecting emotional distance towards others) was significantly and positively associated with urinary cortisol and platelet MAO activity. This seems to reflect the two previously described subgroups of alcoholism, with early and late onset, respectively. In the whole sample, we found a positive correlation between urinary cortisol and Stability. The biological markers showed no clear differences between the MNT clusters. We could not replicate earlier findings of an association between impulsiveness (low solidity) and low levels of 5-HIAA or low MAO activity in platelets in the whole sample of suicide attempters.