SynthesisThe Australian and New Zealand journal of psychiatry2022
How do lipids influence risk of violence, self-harm and suicidality in people with psychosis? A systematic review.
Synthesis in The Australian and New Zealand journal of psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 19 citations in OpenAlex.
- Association Between Biochemical, Inflammatory, Oxidative Stress and DNA Methylation Biomarkers with Perceived Stress in Mexican Individuals.Biomolecules · 2026Article
- Agitation/excitement in male patients with treatment-resistant schizophrenia is associated with lower total cholesterol levels.Frontiers in psychiatry · 2026Article
- Low cholesterol and risk of violence in forensic inpatients with schizophrenia, personality disorder or dual diagnosis: same or different?European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- Sex differences of the lipid profile, impulsivity and suicidality in psychiatric inpatients.Frontiers in psychiatry · 2025Article
- Remnant cholesterol and suicide attempts in untreated first-episode major depressive disorder.Frontiers in psychiatry · 2025Article
- Study on the correlation between serum total cholesterol levels and suicidal ideation in patients with first-episode drug-naïve schizophrenia: a cross-sectional study.Frontiers in psychiatry · 2025Article
- Cytokines and Madness: A Unifying Hypothesis of Schizophrenia Involving Interleukin-22.International journal of molecular sciences · 2024Review
- Evaluation of neutrophile-to-lymphocyte ratio and lipid profile in non-violent suicide attempters: a mechanistic study.Journal of injury & violence research · 2024Article
- Aggression in Women with Schizophrenia Is Associated with Lower HDL Cholesterol Levels.International journal of molecular sciences · 2022Article
- Reseach progress in dual harm.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2022Review
- Metabolic Problems Among People With Treatment-Resistant Schizophrenia are Not Unique to Clozapine.Journal of clinical psychopharmacologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLow cholesterol has been linked with violent and suicidal behaviour in people with schizophrenia. This association, if consistently present, may be a promising biological marker that could assist clinicians in decision making regarding risk and treatment. We conducted a systematic review to assess whether there is a reliable association between lipid profile (total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides) and aggression, self-harm or suicide in people with schizophrenia, and whether effects are similar in males and females.
methodRelevant databases were searched to identify primary research studies (up to November 2020) that (1) involved adults (some samples also included 16- to 18-year olds) with a confirmed diagnosis of schizophrenia, schizoaffective disorder or psychosis; and (2) included a standardised assessment of verbal aggression, physical aggression against objects, physical aggression against self (including suicide) or others. The search yielded 23 studies eligible for inclusion following a quality appraisal.
resultsSuicidality was the most commonly assessed subtype of aggression (20 studies). For suicidality, about half the studies, including the study with the largest sample size, found a link with total cholesterol. An association between low total cholesterol and violence towards others was found in six of nine studies that investigated this. The evidence for a link with violence was the strongest for total cholesterol, followed by low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, and the weakest for triglycerides. Only a few studies investigated sex differences and yielded mixed evidence. Studies focussed on self-harm as well as involving females in forensic settings were lacking.
conclusionThere is encouraging evidence of an association between low total cholesterol and aggression towards others as well as suicidality in schizophrenia. Future studies should systematically explore this association in people with schizophrenia who have a significant history of violence, suicidality and self-harm, both inpatients and community, and also investigate underlying mechanisms.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.