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http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(
The Lancet Psychiatry, Volume 1, Issue 1, Pages 63 - 72, June 2014
Article|Next Article>
doi:10.1016/S2215-0366(14)70220-2Cite or Link Using DOI
Published Online: 02 May 2014
Copyright © 2014 Elsevier Ltd All rights reserved.
The neurobiology of suicide
Prof Kees van Heeringen PhD a Corresponding AuthorEmail Address, Prof J John
Mann MD b
Summary
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.
a Unit for Suicide Research, Department of Psychiatry and Medical Psychology
, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
b Molecular Imaging and Neuropathology Division, Department of Psychiatry,
Columbia University, NY, USA
Corresponding Author Information Correspondence to: Prof Kees van Heeringen,
Unit for Suicide Research, Department of Psychiatry and Medical Psychology,
Faculty of Medicine and Health Sciences, Ghent University, University
Hospital, Ghent 9000, Belgium |
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