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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.

Method:

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.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 1259 - 1277
PubMed: 25263730

History

Received: 14 February 2014
Revision received: 27 June 2014
Revision received: 10 July 2014
Accepted: 14 July 2014
Published ahead of print: 31 October 2014
Published online: 1 December 2014
Published in print: December 01, 2014

Authors

Details

Maria A. Oquendo, M.D.
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.
Gregory M. Sullivan, M.D.
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.
Katherin Sudol, B.A.
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.
Enrique Baca-Garcia, M.D., Ph.D.
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.
Barbara H. Stanley, Ph.D.
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.
M. Elizabeth Sublette, M.D., Ph.D.
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.
J. John Mann, M.D.
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.

Notes

Address correspondence to Dr. Oquendo ([email protected]).

Funding Information

National Institute of Mental Health10.13039/100000025: MH048514, MH090964
Dr. Oquendo receives royalties for the use of the Columbia Suicide Severity Rating Scale (C-SSRS) and has received financial compensation from Pfizer for the safety evaluation of a clinical facility; she was the recipient of a grant from Eli Lilly to support a year’s salary for the Lilly Suicide Scholar, Enrique Baca-Garcia; she has received unrestricted educational grants and/or lecture fees from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen, Otsuko, Pfizer, Sanofi-Aventis, and Shire; and her family owns stock in Bristol-Myers Squibb. Dr. Sullivan is employed by Tonix Pharmaceuticals, and previously served as an adviser and as a consultant for Tonix Pharmaceuticals. Dr. Sublette received a grant of nutritional supplements from Unicity International. Dr. Mann receives royalties from the Research Foundation for Mental Hygiene for commercial use of the C-SSRS; he owns stock options in Qualitas, a producer of EPA supplements. Dr. Stanley receives royalties from the Research Foundation for Mental Hygiene for commercial use of the C-SSRS. The other authors report no financial relationships with commercial interests.Supported by NIMH grants P50 MH090964 and R01 MH48514.

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