Association between low activity serotonin transporter promoter genotype and early onset alcoholism with habitual impulsive violent behavior

T. Hallikainen, T. Saito, H. M. Lachman, J. Volavka, T. Pohjalainen, O. P. Ryynänen, J. Kauhanen, E. Syvälahti, J. Hietala, J. Tiihonen

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217 Scopus citations


A common 44-base pair insertion/deletion polymorphism in the promoter region of the human serotonin transporter (5-HTT) gene has been observed to be associated with affective illness and anxiety-related traits. This biallelic functional polymorphism, designated long (L) and short (S), affects 5-HTT gene expression since the S promoter is less active than the L promoter. Since there is strong evidence of a disturbance in brain serotonergic transmission among antisocial, impulsive, and violent type 2 alcoholic subjects, we decided to test the hypothesis that the frequency of the S allele, which is associated with reduced 5-HTT gene expression, is higher among habitually violent type 2 alcoholics when compared with race and gender-matched healthy controls and non-violent late-onset (type 1) alcoholics. The 5-HTT promoter genotype was determined by a PCR-based method in 114 late onset (type 1) non-violent alcoholics, 51 impulsive violent recidivistic offenders with early onset alcoholism (type 2), and 54 healthy controls. All index subjects and controls were white Caucasian males of Finnish origin. The S allele frequency was higher among type 2 alcoholics compared with type 1 alcoholics (χ2 = 4.86, P = 0.028) and healthy controls (χ2 = 8.24, P = 0.004). The odds ratio for SS genotype vs LL genotype was 3.90, 95% CI 1.37-11.11, P = 0.011 when type 2 alcoholics were compared with healthy controls. The results suggest that the 5-HTT 'S' promoter polymorphism is associated with an increased risk for early onset alcoholism associated with antisocial personality disorder and impulsive, habitually violent behavior.

Original languageEnglish (US)
Pages (from-to)385-388
Number of pages4
JournalMolecular Psychiatry
Issue number4
StatePublished - 1999


  • Alcoholism
  • Polymorphism
  • Serotonin transporter
  • Violent behavior

ASJC Scopus subject areas

  • Molecular Biology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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