title: Toward a biosignature for suicide.
abstract: OBJECTIVE
  Suicide, a major cause of death worldwide, has distinct biological underpinnings. The authors review and synthesize the research literature on biomarkers of suicide, with the aim of using the findings of these studies to develop a coherent model for the biological diathesis for suicide.
  
  
  METHODS
  The authors examined studies covering a large range of neurobiological systems implicated in suicide. They provide succinct descriptions of each system to provide a context for interpreting the meaning of findings in suicide.
  
  
  RESULTS
  Several lines of evidence implicate dysregulation in stress response systems, especially the hypothalamic-pituitary-adrenal axis, as a diathesis for suicide. Additional findings related to neuroinflammatory indices, glutamatergic function, and neuronal plasticity at the cellular and circuitry level may reflect downstream effects of such dysregulation. Whether serotonergic abnormalities observed in individuals who have died by suicide are independent of stress response abnormalities is an unresolved question.
  
  
  CONCLUSIONS
  The most compelling biomarkers for suicide are linked to altered stress responses and their downstream effects, and to abnormalities in the serotonergic system. Studying these systems in parallel and in the same populations may elucidate the role of each and their interplay, possibly leading to identification of new treatment targets and biological predictors.
authors.affiliation: From the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York; the Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York; the Centers for Biomedical Research Network on Mental Health (CIBERSAM), Madrid; and the Department of Psychiatry, Fundación Jiménez Diaz Hospital and Autonomous University of Madrid.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Oquendo
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Sullivan
authors.forename: Katherin
authors.initials: K
authors.lastname: Sudol
authors.forename: Enrique
authors.initials: E
authors.lastname: Baca-Garcia
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Stanley
authors.forename: M Elizabeth
authors.initials: ME
authors.lastname: Sublette
authors.forename: J John
authors.initials: JJ
authors.lastname: Mann
mesh_terms: D015415:Biomarkers / Q000378:metabolism*; D001921:Brain / Q000378:metabolism* / Q000503:physiopathology; D004298:Dopamine / Q000378:metabolism; D005786:Gene Expression Regulation; D018698:Glutamic Acid / Q000378:metabolism; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism* / Q000503:physiopathology; D007249:Inflammation / Q000378:metabolism / Q000503:physiopathology; D008125:Locus Coeruleus / Q000378:metabolism* / Q000503:physiopathology; D009473:Neuronal Plasticity; D018377:Neurotransmitter Agents / Q000378:metabolism*; D009638:Norepinephrine / Q000378:metabolism; D010913:Pituitary-Adrenal System / Q000378:metabolism* / Q000503:physiopathology; D012701:Serotonin / Q000378:metabolism; D013315:Stress, Psychological / Q000378:metabolism* / Q000503:physiopathology; D013405:Suicide; D005680:gamma-Aminobutyric Acid / Q000378:metabolism
chemical_list: D015415:Biomarkers; D018377:Neurotransmitter Agents; D012701:Serotonin; D018698:Glutamic Acid; D005680:gamma-Aminobutyric Acid; D004298:Dopamine; D009638:Norepinephrine