Department of Psychiatry, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Psychiatry, Uijeongbu St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Asia Pac Psychiatry. 2017 Dec;9(4). doi: 10.1111/appy.12291. Epub 2017 Jun 21.
Suicide is a world health priority. Studies over the last few decades have revealed the complexity underlying the neurobiological mechanisms of suicide. Researchers have found dysregulations in the serotonergic system, the stress system, neural plasticity, lipid metabolism, and cell signaling pathways in relation to suicidal behaviors. These findings have provided more insight into the final path leading to suicide, at which medical intervention should be applied to prevent the action. However, because these molecular mechanisms have been implicated in both depression and suicide, the specificity of the mechanisms has been obscured. In this review, we summarize the main findings of studies on molecular mechanisms of suicidal behavior from the last 2 decades, with particular emphasis on the potential, independent role of each mechanism that is not contingent upon an underlying psychopathology, such as depression. The act of suicide is multifactorial; no single molecular mechanism is sufficient to fully account for the act. Knowledge of the reciprocal interactions among these molecular mechanisms and studying them in the context of brain circuitry by using neuroimaging techniques will provide a better understanding of the neurobiology of suicide.
自杀是全球卫生重点关注的问题之一。过去几十年的研究揭示了自杀的神经生物学机制背后的复杂性。研究人员发现，与自杀行为相关的 5-羟色胺能系统、应激系统、神经可塑性、脂质代谢和细胞信号通路存在失调。这些发现为最终导致自杀的途径提供了更多的了解，在这一途径中，应该进行医学干预以防止自杀行为的发生。然而，由于这些分子机制与抑郁和自杀都有关联，因此机制的特异性被掩盖了。在这篇综述中，我们总结了过去 20 年中关于自杀行为分子机制的主要研究结果，特别强调了每个机制的潜在、独立作用，而不是依赖于潜在的精神病理学，如抑郁。自杀行为是多因素的；没有单一的分子机制足以完全解释这一行为。了解这些分子机制之间的相互作用，并通过使用神经影像学技术在大脑回路的背景下研究它们，将有助于更好地理解自杀的神经生物学。
