Suicide attempt and n-3 fatty acid levels in red blood cells: a case control study in China

Biol Psychiatry. 2004 Oct 1;56(7):490-6. doi: 10.1016/j.biopsych.2004.06.028.


Background: Epidemiologic studies show that low fish intake is a risk factor of suicidality; however, there are no case-control studies investigating suicide attempt risk and tissue n-3 fatty acid levels.

Methods: We recruited 100 suicide-attempt cases and another 100 control patients injured by accidents who were admitted to three hospitals affiliated with Dalian Medical University in Dalian, China. Case and control subjects were matched for age, gender, and smoking status. Those who were inebriated at the time of hospitalization were excluded. Blood was sampled immediately after admission to a hospital. Washed red blood cells (RBCs) were obtained, and the fatty acid composition of the total RBC phospholipid fraction was analyzed by gas chromatography.

Results: Eicosapentaenoic acid (EPA) levels in RBC in the case subjects were significantly lower than those of the control subjects (.74 +/-.52% vs. 1.06 +/-.62%, p <.0001). When the highest and lowest quartiles of EPA in RBC were compared, the odds ratios of suicide attempt was.12 in the highest quartile (95% confidence interval:.04-.36, p for trend =.0001) after adjustment for possible confounding factors

Conclusions: Our findings suggest that low n-3 fatty acid levels in tissues were a risk factor of suicide attempt. Further studies including intervention with fish oil are warranted.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Animals
  • Case-Control Studies
  • China
  • Comorbidity
  • Depression / epidemiology
  • Docosahexaenoic Acids / blood*
  • Eicosapentaenoic Acid / blood*
  • Erythrocytes / chemistry*
  • Fatty Acids / blood
  • Fatty Acids, Omega-3 / blood*
  • Fatty Acids, Omega-6 / blood
  • Fatty Acids, Unsaturated / blood
  • Feeding Behavior
  • Female
  • Fishes
  • Humans
  • Male
  • Matched-Pair Analysis
  • Middle Aged
  • Neuropsychological Tests
  • Odds Ratio
  • Risk Factors
  • Suicide, Attempted* / statistics & numerical data


  • Fatty Acids
  • Fatty Acids, Omega-3
  • Fatty Acids, Omega-6
  • Fatty Acids, Unsaturated
  • Docosahexaenoic Acids
  • Eicosapentaenoic Acid