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[自杀行为的神经生物学]

[Neurobiology of suicidal behaviour].

作者信息

Jaeschke Rafał, Siwek Marcin, Dudek Dominika

机构信息

Klinika Psychiatrii Dorosłych Szpitala Uniwersyteckiego w Krakowie.

出版信息

Psychiatr Pol. 2011 Jul-Aug;45(4):573-88.

Abstract

The authors of this paper present a review of actual data on the neurobiological background of suicidal behaviour. The results of epidemiological studies suggest that suicidal behaviours have certain genetic background which do not depend on the presence of concomitant mental disorders. The estimated heritability rate of suicide is about 21-50%, while the heritability rate of suicidal ideation and behaviour is about 30-55%. The genes of serotonergic and noradrenergic systems, as well as the HPA axis genes, have been scrutinised in context of suicidal behaviour. Epigenetic factors are also believed to be involved in the pathogenesis of suicide. Serotonergic, noradrenergic, glutamatergic and GABAergic systems, as well as the HPA axis, are the main neural networks involved in the pathophysiology of suicide. Disorders of opioid and endocannabinoid systems can also be found in suicide victims. Pathogenesis of suicidal behaviour also contains abnormalities of cell signalising and pathology ofglial cells. Neurobiological background of akathisia and impulsivity (clinical issues closely related to the pathogenesis of suicidal behaviour) have also been presented. Most of the available trials on neurobiological background of suicidal behaviour have significant methodological weaknesses, making the results difficult to interpret. Usually they contain small samples and only single biological variables (without adjustment on environmental factors) are being analysed.

摘要

本文作者对自杀行为的神经生物学背景的实际数据进行了综述。流行病学研究结果表明,自杀行为具有一定的遗传背景,且不依赖于伴发的精神障碍的存在。自杀的估计遗传率约为21%-50%,而自杀意念和行为的遗传率约为30%-55%。血清素能和去甲肾上腺素能系统的基因,以及下丘脑-垂体-肾上腺(HPA)轴基因,已在自杀行为的背景下进行了仔细研究。表观遗传因素也被认为参与了自杀的发病机制。血清素能、去甲肾上腺素能、谷氨酸能和γ-氨基丁酸能系统,以及HPA轴,是参与自杀病理生理学的主要神经网络。在自杀受害者中也可发现阿片类和内源性大麻素系统的紊乱。自杀行为的发病机制还包括细胞信号传导异常和神经胶质细胞病变。本文还介绍了静坐不能和冲动性(与自杀行为发病机制密切相关的临床问题)的神经生物学背景。关于自杀行为神经生物学背景的大多数现有试验存在重大方法学缺陷,导致结果难以解释。通常这些试验样本量小,且仅分析单一生物学变量(未对环境因素进行调整)。

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