This article is more than 5 years old. Information may no longer be current.

New neurobiological approaches identified for suicide prevention

In the first in a series of three papers on suicide published in Lancet Psychiatry, researchers discussed the neurobiology of suicide and future approaches for prevention, including repetitive transcranial magnetic stimulation, psychopharmacological compounds, genomic markers and neuroimaging.

The researchers explored the stress–diathesis model in which suicidal behavior is a result of stressors (environmental) and a susceptibility to suicidal behavior. About half of the risk for suicide due to diathesis is inherited, according to the paper.

Changes in cell types of the cortical and subcortical areas of the brain have been reported in post-mortem studies of suicide deaths, according to researchers. Additionally, research has shown the number of mature granule neurons in the hippocampus is lower in people with untreated depression who died by suicide than those treated with selective serotonin-reuptake inhibitors.

Brain circuitry is also an indicator of suicide and depression.

“Two brain regions, one in the anterior cingulate and medial prefrontal cortex, and one in the lateral prefrontal cortex, were shown to have activity that was correlated with lethality of suicidal behavior in people with major depression,” the researchers wrote.

As for life stressors, early-life adversity is one of the strongest risk factors for suicidal behavior throughout life, particularly physical and sexual abuse.

Although the specific genes have not been identified, about half of the risk for suicide or suicide attempts is genetic, according to researchers.

Other neurobiological factors in the diathesis for suicidal behavior include serotonin transmission, noradrenergic transmission and the hypothalamic-pituitary-adrenal axis.

“Genomics and brain imaging are the most promising new directions for detection of patients at high risk for suicide. … Brain imaging might help to identify people at risk of a more lethal suicide attempt or suicide,” the researchers wrote.

Disclosures: One of the researchers receives royalties for commercial use of the Columbia Suicide Severity Rating Scale from the Research Foundation for mental Hygiene and has stock options in Qualitas Health. Van Heeringen reports no relevant financial disclosures.