There is some (but by no means overwhelming) evidence for increased suicide and accidental death associated with low cholesterol:
Nippon Rinsho. 2001 Aug;59(8):1599-604. Related Articles,Links
[Low serum cholesterol and suicidal behavior]
[Article in Japanese]
Kunugi H.
Department of Psychiatry, Teikyo University School of Medicine.
An increasing number of studies have shown that low serum cholesterol levels are associated with a risk of suicidal, violent, and impulsive behaviors. This article reviewed the literature on this possible association. Several randomized controlled trials of lowering cholesterol interventions did not reduce total mortality in spite of reduced mortality due to coronary heart disease. This is partly attributable to an increased mortality rate of death due to suicide or accidents among individuals with lowered serum cholesterol. Cohort studies have shown that individuals with low serum cholesterol levels are more likely to present depressive symptoms and suicidal acts in later years than those with higher cholesterol levels. Many studies comparing suicidal and control subjects have found an association between low serum cholesterol and suicidal behavior. Although contradictive results are also reported, further studies are warranted to conclude the possible relationship between low or lowering serum cholesterol and suicidal behavior. Clinicians should be aware of potential effects of lowering cholesterol interventions on behavioral symptoms.
BMJ. 2001 Jan 6;322(7277):11-5. Related Articles,Links
Cholesterol reduction and non-illness mortality: meta-analysis of randomised clinical trials.
Muldoon MF, Manuck SB, Mendelsohn AB, Kaplan JR, Belle SH.
Center for Clinical Pharmacology, University of Pittsburgh School of Medicine, PA 15260, Pittsburgh, USA. mfm10_@pitt.edu
OBJECTIVE: To investigate the association between cholesterol lowering interventions and risk of death from suicide, accident, or trauma (non-illness mortality). DESIGN: Meta-analysis of the non-illness mortality outcomes of large, randomised clinical trials of cholesterol lowering treatments. STUDIES REVIEWED: 19 out of 21 eligible trials that had data available on non-illness mortality. INTERVENTIONS REVIEWED: Dietary modification, drug treatment, or partial ileal bypass surgery for 1-10 years. MAIN OUTCOME MEASURE: Deaths from suicides, accidents, and violence in treatment groups compared with control groups. RESULTS: Across all trials, the odds ratio of non-illness mortality in the treated groups, relative to control groups, was 1.18 (95% confidence interval 0.91 to 1.52; P=0.20). The odds ratios were 1.28 (0.94 to 1.74; P=0.12) for primary prevention trials and 1.00 (0.65 to 1.55; P=0.98) for secondary prevention trials. Randomised clinical trials using statins did not show a treatment related rise in non-illness mortality (0.84, 0.50 to 1.41; P=0.50), whereas a trend toward increased deaths from suicide and violence was observed in trials of dietary interventions and non-statin drugs (1.32, 0.98 to 1.77; P=0.06). No relation was found between the magnitude of cholesterol reduction and non-illness mortality (P=0.23). CONCLUSION: Currently available evidence does not indicate that non-illness mortality is increased significantly by cholesterol lowering treatments. A modest increase may occur with dietary interventions and non-statin drugs.
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