Association of aggressive behavior with altered serotonergic function in patients who are not suicidal

Am J Psychiatry. 2000 Apr;157(4):609-14. doi: 10.1176/appi.ajp.157.4.609.


Objective: The purpose of this study was to determine whether aggression and serotonergic dysfunction are related in the absence of a history of suicidal behavior. Although serotonergic dysfunction has been implicated in aggressive and impulsive behavior, most studies of such behavior have included individuals with a history of suicide attempts. Low concentrations of CSF 5-hydroxyindoleacetic acid (5-HIAA) have been consistently associated with suicidal behavior, presenting a potential confound in the link between aggression and serotonergic dysfunction.

Method: The authors examined the association between aggression and CSF 5-HIAA concentrations in a group of 64 patients who had different DSM-III-R axis I diagnoses and no past suicidal behavior. Aggressive (N=35) and nonaggressive (N=29) groups were defined by a median split on a six-item history of adulthood aggressive behavior.

Results: The aggressive group had significantly lower CSF 5-HIAA concentrations than the nonaggressive group. Aggressive individuals also scored significantly higher on self-report measures of hostility, impulsiveness, and sensation seeking. CSF 5-HIAA concentrations, however, did not correlate with self-reported hostility and impulsivity.

Conclusions: There is an association between aggressive behavior and serotonergic dysfunction independent of suicidal behavior in patients with axis I disorders who exhibit relatively milder forms of aggressive behavior. Analogous to findings with suicidal behavior, a low concentration of CSF 5-HIAA is related to aggressive behavior but does not show the same relationship to the continuum of aggressive feelings and thoughts.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aggression / physiology*
  • Aggression / psychology
  • Brief Psychiatric Rating Scale
  • Female
  • Humans
  • Hydroxyindoleacetic Acid / cerebrospinal fluid
  • Impulsive Behavior / cerebrospinal fluid
  • Impulsive Behavior / diagnosis
  • Impulsive Behavior / physiopathology
  • Male
  • Mental Disorders / cerebrospinal fluid
  • Mental Disorders / diagnosis
  • Mental Disorders / physiopathology*
  • Personality Inventory
  • Psychiatric Status Rating Scales
  • Serotonin / physiology*
  • Suicide / psychology
  • Suicide / statistics & numerical data*


  • Serotonin
  • Hydroxyindoleacetic Acid