title: The neurobiology of suicide.
abstract: The stress-diathesis model posits that suicide is the result of an interaction between state-dependent (environmental) stressors and a trait-like diathesis or susceptibility to suicidal behaviour, independent of psychiatric disorders. Findings from post-mortem studies of the brain and from genomic and in-vivo neuroimaging studies indicate a biological basis for this diathesis, indicating the importance of neurobiological screening and interventions, in addition to cognitive and mood interventions, in the prevention of suicide. Early-life adversity and epigenetic mechanisms might explain some of the link between suicide risk and brain circuitry and neurochemistry abnormalities. Results from a range of studies using diverse designs and post-mortem and in-vivo techniques show impairments of the serotonin neurotransmitter system and the hypothalamic-pituitary-adrenal axis stress-response system in the diathesis for suicidal behaviour. These impairments manifest as impaired cognitive control of mood, pessimism, reactive aggressive traits, impaired problem solving, over-reactivity to negative social signs, excessive emotional pain, and suicidal ideation, leading to suicidal behaviour. Biomarkers related to the diathesis might help to inform risk-assessment procedures and treatment choice in the prevention of suicide.
authors.affiliation: Unit for Suicide Research, Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. Electronic address: cornelis.vanheeringen@ugent.be.
authors.forename: Kees
authors.initials: K
authors.lastname: van Heeringen
authors.affiliation: Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, NY, USA.
authors.forename: J John
authors.initials: JJ
authors.lastname: Mann