January 27, 1997

Caffeine as a Stimulant Against Suicide

Author Affiliations

Woodside, NY

Arch Intern Med. 1997;157(2):243-244. doi:10.1001/archinte.1997.00440230123020

In a recent article, Kawachi et al1 found an inverse correlation between coffee drinking and suicide in a cohort of 121 700 female registered nurses. The authors attributed their results to the mood-elevating effect of coffee. While I agree with the mood-altering mechanism, I suggest that there is a more revealing explanation for the problem. First, I propose a diagnostic distinction within suicide. Impulsive suicides may result from an imbalance in levels of serotonin; they may not necessarily be associated with depression; they could result from an instant decision; and they often are violent.2 Nonimpulsive suicides are frequently related to frontal cortex understimulation; they can show repetitive attempt patterns; they are usually planned; and they frequently involve less violent means (eg, drug overdose). Naturally, there can be a combined mechanism as well. A typical nonimpulsive subject sets a date for his or her attempt. He or she receives

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