Elsevier

Medical Hypotheses

Volume 89, April 2016, Pages 40-42
Medical Hypotheses

Is violence in part a lithium deficiency state?

https://doi.org/10.1016/j.mehy.2016.02.002Get rights and content

Abstract

Violence, particularly firearm violence, leading to suicide and homicide is a significant problem worldwide. A majority of suicidal and homicidal violence involves males; homicidal violence is prevalent among young men and suicide is the leading cause of violence worldwide. Lithium, in pharmacological doses, has been used successfully for decades in treating bipolar disorders, and has been shown to decrease violent crime in this situation. Interestingly, lithium, in trace amounts, as occurs in some drinking water, has been inversely related to aggression, and suicidal and homicidal violence. Lithium is naturally found in vegetables, grains and drinking water, and dietary intake varies from nearly zero to 3 mg daily. Elemental lithium, in trace doses, has been shown to improve mood in weeks. Moreover, lithium, in trace amounts, has no toxicity. In order to ensure adequate dietary intakes of elemental lithium daily for the purpose of decreasing aggression and violence, we propose considering the fortification of cereal grain products with lithium and also the addition of lithium to vitamin preparations for adults. Importantly, randomized trials in various populations are needed to test this hypothesis.

Introduction

The discussion of violence, particularly firearm violence, has come to the forefront in the United States as a result of mass shootings in public places that have appropriately received comprehensive and widespread news coverage. This has spurred intense and passionate debate on gun control and other methods to control the apparent escalation of homicidal firearm violence [1]. In 2012, there were a total of 32,288 fatalities from firearm violence, comprising 20,666 suicides and 11,622 homicides [2]. Mass shootings in public places, although horrific, make up a very small percentage of total homicides.

Interestingly, mental illness is not the main driver of firearm homicides; however, depression is a major risk factor for firearm suicides [2]. After age 34, suicide is the leading cause of firearm death, and in the ninth decade suicide comprises approximately 95% of firearm death. Gender and racial differences are evident in firearm mortality; young black compared to white men have particularly high homicide mortality, and overall, men compared to women comprise a large majority of overall firearm fatalities [2].

Global violence has similarities to violence in the United States and suicides are the main cause of violent death [3]. Moreover, homicide vulnerability is largely seen among adolescents and young men, and the majority of violent suicide and homicide fatalities involve men.

Section snippets

Aggression and violence

Aggressive behavior is common among animals and has served a purpose to preserve life throughout evolution; it bolstered the ability to obtain food, defend against predators, and find females for reproduction [4]. In vertebrates, including humans, aggression is more pronounced among males compared to females, which is in part testosterone related [4]. In other words, male adolescents and young men, in particular, are biologically programmed to be aggressive. As such, it is not surprising that

Lithium: an important but neglected trace element

Lithium has been used for many decades to treat manic depression and only recently have its numerous mechanisms of action begun to be elucidated [9]. Lithium stimulates the production of neural stem cells and has been shown to increase amygdala and hippocampus volume and neurogenesis, and grey matter density in patients with bipolar disorders [9], [10]. Additionally, via multiple pathways, lithium inhibits the enzyme glycogen synthase kinase-3β (GSK-3β), which in turn leads to the activation of

Hypothesis

We propose the fortification of food with trace amounts of lithium and the addition of trace amounts of lithium to adolescent and adult vitamin preparations. We believe this strategy will decrease aggression, violence, suicide and homicide. Importantly, there will be no toxicity encountered.

Lithium fortification of food is worth serious consideration

As previously noted, trace amounts of lithium in drinking water compared to little or no lithium in drinking water have been associated with a significant decrease in aggression, homicide and suicide [12], [13]. It is interesting that scalp hair lithium levels reflect dietary intakes of lithium over the preceding weeks to months, and a study has shown that the scalp hair lithium content of California healthy men was threefold that of California violent offenders [24]. As mentioned, trace

Conflict of interest

None.

Acknowledgement

None.

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  • Cited by (24)

    • Lithium in drinking water sources in rural and urban communities in Southeastern Nigeria

      2020, Chemosphere
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      There is growing evidence from ecological studies that lithium traces in drinking water may protect against suicide. Studies showing evidence of an inverse correlation between Li concentrations in drinking water and suicide rates (Schrauzer and Shrestha, 1990; Ohgami et al., 2009; Kapusta et al., 2011; Blüml et al., 2013; Giotakos et al., 2013; Ishii et al., 2015; Goldstein and Mascitelli, 2016) outnumber the studies that found no correlation between lithium concentrations in drinking water and suicide rates (Kabacs et al., 2011; Pompili et al., 2015), which could be related to the Li levels in the selection of their case-control samples. A recent study by Shimodera et al. (2018) investigated lithium level in tap water in relation to psychotic experiences in a general population of adolescents and reported an inverse relationship, while Ando et al. (2017) could only established an inverse association between Li level in tap water and depressive symptoms and interpersonal violence but not suicide.

    • Relationship between suicide mortality and lithium in drinking water: A systematic review and meta-analysis

      2020, Journal of Affective Disorders
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      The lithium intake from other sources such as food (grains and vegetables) was not considered in the examined studies. This is while research has shown that drinking water can constitute only one-third of lithium intake in some regions (Goldstein and Mascitelli, 2016). Moreover, nearly all studies used public waterworks as the main source of drinking water supply, ignoring other sources such as bottled mineral water and wells, which usually have higher amounts of lithium (Kapusta et al., 2011; Pompili et al., 2015).

    • Lithium as an emerging environmental contaminant: Mobility in the soil-plant system

      2018, Chemosphere
      Citation Excerpt :

      Relatively low concentrations affect the central nervous system, with reports that drinking water concentrations >0.17 mg/L reduce the incidence of suicide (Schrauzer and Shrestha, 1990) and also that concentrations >0.015 mg/L are protective against dementia (Kessing et al., 2017). Of course, Li is used in medications for bipolar disorder and manic and depressive episodes, and Goldstein and Mascitelli (2016) hypothesised that increased Li intake would reduce levels of aggression and violence. Humans may be exposed to increasing Li concentrations as it enters the environment through the use and disposal of Li-containing products.

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