The neurobiology of suicide and suicidality.
OBJECTIVE
To investigate the current state of knowledge regarding the neurobiology of suicide and suicidality.


METHODS
The literature on the neurobiology of suicidality and suicide was reviewed.


RESULTS
There is clear evidence that the activity of 3 neurobiological systems has a role in the pathophysiology of suicidal behaviour. This includes hyperactivity of the hypothalamo-pituitary-adrenal axis, dysfunction of the serotonergic (5-HTergic) system, and excessive activity of the noradrenergic system. While the first and the last system appear to be involved in the response to stressful events, dysfunction of the serotonergic system is thought to be trait-dependent and associated with disturbances in the regulation of anxiety, impulsivity, and aggression. It can be hypothesized that neurobiological dysfunctions mediate the occurrence of suicidal behaviour through the disturbed modulation of basic neuropsychological functions.


CONCLUSIONS
Increasing insight into the neurobiological basis of suicidal behaviour suggests that serotonin (5-HT) agonists have an important role in the treatment and prevention of suicidal behaviour. Studies of the efficacy of such drugs have, however, been disappointing. Because suicidal behaviour continues to be a major public health problem, further study is clearly needed, including research on the effect of combined pharmacologic and psychotherapeutic approaches.
van Heeringen
Kees
K
Unit for Suicide Research, University Dept of Psychiatry, University Hospital, De Pintelaan 185, B-9000 Gent, Belgium. cornelis.vanheeringen@rug.ac.be
D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D001008:Anxiety Disorders / Q000503:physiopathology* / Q000628:therapy; D001665:Binding Sites; D001921:Brain / Q000378:metabolism / Q000503:physiopathology*; D003131:Combined Modality Therapy; D003346:Corticotropin-Releasing Hormone / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology*; D008016:Life Change Events; D009638:Norepinephrine / Q000378:metabolism; D010913:Pituitary-Adrenal System / Q000378:metabolism / Q000503:physiopathology*; D011388:Prolactin / Q000378:metabolism; D011613:Psychotherapy; D012701:Serotonin / Q000378:metabolism / Q000502:physiology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology
D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone; D009638:Norepinephrine; D011388:Prolactin; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors