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双相情感障碍中自杀及自杀未遂的神经生物学方面

NEUROBIOLOGICAL ASPECTS OF SUICIDE AND SUICIDE ATTEMPTS IN BIPOLAR DISORDER.

作者信息

Mathews Daniel C, Richards Erica M, Niciu Mark J, Ionescu Dawn F, Rasimas Joseph J, Zarate Carlos A

机构信息

Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.

出版信息

Transl Neurosci. 2013 Jun;4(2). doi: 10.2478/s13380-013-0120-7.

Abstract

Suicide and bipolar disorder (BD) are challenging, complex, and intertwined areas of study in contemporary psychiatry. Indeed, BD is associated with the highest lifetime risk for suicide attempt and completion of all the psychiatric conditions. Given that several clinical risk factors for both suicide and BD have been well noted in the literature, exploring the neurobiological aspects of suicide in BD may provide insights into both preventive measures and future novel treatments. This review synthesizes findings regarding the neurobiological aspects of suicide and, when applicable, their link to BD. Neurochemical findings, genes/epigenetics, and potential molecular targets for current or future treatments are discussed. The role of endophenotypes and related proximal and distal risk factors underlying suicidal behavior are also explored. Lastly, we discuss the manner in which preclinical work on aggression and impulsivity may provide additional insights for the future development of novel treatments.

摘要

自杀与双相情感障碍(BD)是当代精神病学中具有挑战性、复杂性且相互交织的研究领域。事实上,在所有精神疾病中,BD与一生中自杀未遂及自杀成功的最高风险相关。鉴于自杀和BD的若干临床风险因素在文献中已得到充分记载,探索BD中自杀的神经生物学方面可能为预防措施和未来新疗法提供见解。本综述综合了关于自杀神经生物学方面的研究结果,并在适用时阐述其与BD的联系。讨论了神经化学研究结果、基因/表观遗传学以及当前或未来治疗的潜在分子靶点。还探讨了内表型的作用以及自杀行为背后相关的近端和远端风险因素。最后,我们讨论了关于攻击和冲动的临床前研究可能为新疗法的未来发展提供额外见解的方式。

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