Citation

Caceda R. Rev. Neuropsiquiatr. 2014; 77(1): 3-18.

Copyright

(Copyright © 2014, Universidad Nacional Mayor De San Marcos)

DOI

unavailable

PMID

unavailable

Abstract

Approximately one million people worldwide die from suicide every year. High risk populations include active military, adolescents, the elderly and the chronically mentally and physically ill. More than 90% of suicides are in individuals with a diagnosable psychiatric disorder. Practically all of the major psychiatric disorders are associated with an increased risk for suicide, but depression accounts for more than half of the cases. Clinical observation, epidemiological studies, psychological autopsies, genetics, neurochemistry and brain imaging have yielded important findings that have contributed to our increased understanding of suicide. The strongest biological factor associated with suicide is decreased serotonergic neurotransmission, particularly in the ventral prefrontal cortex. Deficits in ventromedial prefrontal cortex function are associated with impulsivity and impaired decision making. Additionally, a burgeoning body of evidence supports a central role of other biogenic amines and the hypothalamic-pituitary-adrenal (HPA) axis in suicide diathesis. Cognitive and psychological factors for high suicide risk include hopelessness, psychological or mental pain, impulsivity, poor problem solving skills, perfectionism, and self-dislike. Strong protective factors against suicide include access and utilization of healthcare resources, connectedness to family and community, and culture and religious beliefs that discourage suicide. Despite this plethora of research, we still lack reliable predictors of suicide risk and must rely heavily upon self-report and clinical judgment. Thus, it remains singularly difficult to predict who is going to commit suicide. Therefore, there is an urgent unmet need to develop effective early detection methods and treatments, particularly for high-risk populations.

Language: en