HYPOCHOLESTEROLEMIA AND AFFECTIVE-DISORDERS

The authors' specific aim was to assess hypocholesterolemia in 203 patients hospitalized because of affective disorders (depression, bipolar disorder, and schizoaffective disorder) compared with 1,595 self-referred subjects in an urban supermarket screening and with 11,864 subjects in the National Health and Nutrition Examination Survey II, a national probability sample. Low plasma cholesterol concentrations (<160 mg/dL) were much more common in patients with affective disorders (20%) than in urban supermarket screenees (4%, P less than or equal to 0.001) or in the National Health and Nutrition Examination Survey II subjects (10%, P less than or equal to 0.001). When paired with supermarket screenees by age and sex, patients with affective disorders had much lower plasma total cholesterol (P less than or equal to 0.0002), low-density lipoprotein cholesterol (P less than or equal to 0.001), and high-density lipoprotein cholesterol (P less than or equal to 0.0001), and higher triglyceride concentrations (P less than or equal to 0.03). Neither the severity of the affective disorders nor severity-age interactions were associated with plasma cholesterol concentrations (P > 0.1); age and plasma cholesterol were positively associated (P = 0.01). None of the psychoactive drugs had a significant independent association with the patients' low-density lipoprotein cholesterol. Plasma cholesterol in patients hospitalized with affective disorders is shifted markedly downward toward hypocholesterolemic concentrations (<160 mg/dL). There is no evidence that low plasma cholesterol could cause or worsen affective disorders.