title: Hypothalamic pituitary adrenal axis and prolactin abnormalities in suicidal behavior.
abstract: Hypothalamic-Pituitary-Adrenal (HPA) axis hyperactivity measured with the dexamethasone suppression test and the dexamethesone/CRH test may have some predictive power for suicidal behavior in patients with mood disorders. Increased prolactin (PRL) levels may be related both to physiological and pathological conditions. HPA-axis abnormalities and increased levels of PRL may coexist, and common neuroendocrine changes may activate both HPA axis and PRL release. HPA-axis hyperactivity is presumably present in a large subpopulation of depressed subjects. Suicidal behavior is considered to be a form of inward-directed aggression, and aggressive behavior has been connected to high androgen levels. However, lower plasma total testosterone levels have also been reported in subjects with depression and higher suicidality. Lipid/immune dysregulations, the increased ratio of blood fatty acids, and increased PRL levels may each be associated with the increased production of pro-inflammatory cytokines, which have been reported in patients with major depression and patients engaging in suicidal behavior. Although no studies have been done to determine whether ante-mortem physical stress may be detected by raised post-mortem PRL, this would be of great interest for physicians.
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs - Sant'Andrea Hospital, "Sapienza" University of Rome, 1035-1039, Via di Grottarossa, 00189, Rome, Italy. maurizio.pompili@uniroma1.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Gianluca
authors.initials: G
authors.lastname: Serafini
authors.forename: Mario
authors.initials: M
authors.lastname: Palermo
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Seretti
authors.forename: Henry
authors.initials: H
authors.lastname: Stefani
authors.forename: Gloria
authors.initials: G
authors.lastname: Angeletti
authors.forename: David
authors.initials: D
authors.lastname: Lester
authors.forename: Mario
authors.initials: M
authors.lastname: Amore
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D003907:Dexamethasone; D006801:Humans; D006966:Hyperprolactinemia / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D011388:Prolactin / Q000378:metabolism*; D013405:Suicide; D013406:Suicide, Attempted
chemical_list: D015415:Biomarkers; D003907:Dexamethasone; D011388:Prolactin