Impulsivity in Male Patients with Treatment- Resistant Schizophrenia Is Associated with Lower Total Cholesterol Levels

Background Treatment-Resistant Schizophrenia (TRS) in males with impulsive and violent behavior poses a clinical challenge. The pathophysiological mechanisms of impulsivity in Male TRS remain unclear. This study explores these mechanisms and investigates potential biomarkers for impulsivity. Method 180 Male TRS patients and 100 healthy controls were enrolled. Psychiatric symptoms and impulsivity were assessed using the Positive and Negative Syndrome Scale 5-factor model (PANSS-5F) and the PANSS-Excited Component (PANSS-EC). Patients were divided into Male TRS with impulsivity (n = 80) and without impulsivity (n = 100). Demographic data and lipid profiles (triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein) were collected for both groups. Statistical analyses assessed the relationship between lipid profiles and impulsivity. Results A negative correlation was found between total cholesterol (TC) levels and impulsivity in Male TRS. Those with impulsivity had worse educational and marital status and more severe cognitive impairment. TC levels and hypercholesterolemia were higher in Male TRS compared to healthy controls. Conclusions Lower TC levels in Male TRS with impulsivity are associated with higher impulsivity risk. TC may be a potential biomarker for impulsivity in this population.