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  • Original Article
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Violent behavior associated with hypocholesterolemia due to a novel APOB gene mutation

Abstract

A 26-year-old male, the index patient, presented with persecutory delusions and suicidal behavior. He had 10 paternal male relatives in two prior generations. Five of them died by violent suicide and one, of the five, also committed a double homicide. The index patient was found to be hypocholesterolemic due to being heterozygous for a novel mutation of apolipoprotein B (apoB-29.4). His mother and paternal grandmother were normocholesterolemic, whereas a surviving paternal uncle was hypocholesterolemic and heterozygous for the apoB-29.4 mutation. This indicated that the index patient's father and paternal grandfather, both of which died by violent suicide, were obligate heterozygotes for the apoB-29.4 mutation and that the index patient inherited the mutation from his paternal grandfather. The odds ratio for the association between hypocholesterolemia and violent behavior in this family, where cholesterol status was known, was 16.9 (95% confidence interval 1.1–239.3). Therefore, our results support an inheritable relationship between violent behavior and hypocholesterolemia.

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Acknowledgements

This work was supported by grants from the Health Research Council of New Zealand (04/141R), the Schizophrenia Fellowship of New Zealand (to PFE and NRP), the Royal Perth Hospital Medical Research Foundation, the Raine Medical Research Foundation, the National Health & Medical Research Council (403908) and the National Heart Foundation of Australia (G 139 115) (to JRB). We are indebted to Dr K Ungerer (Canterbury District Health Board Laboratories) for his assistance.

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Correspondence to P F Edgar.

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Edgar, P., Hooper, A., Poa, N. et al. Violent behavior associated with hypocholesterolemia due to a novel APOB gene mutation. Mol Psychiatry 12, 258–263 (2007). https://doi.org/10.1038/sj.mp.4001910

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