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Tibor Szekely, ChemEng
Woodside, NY

Arch Intern Med. 1997;157(2):243-244.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

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 . . . [Full Text PDF of this Article]

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