School of Psychology, University of Leeds, Leeds, United Kingdom.
School of Psychology, University of Leeds, Leeds, United Kingdom.
Int Rev Neurobiol. 2020;152:101-130. doi: 10.1016/bs.irn.2019.11.006. Epub 2020 Jan 27.
Suicide is a global health issue accounting for at least 800,000 deaths per annum. Numerous models have been proposed that differ in their emphasis on the role of psychological, social, psychiatric and neurobiological factors in explaining suicide risk. Central to many models is a stress-diathesis component which states that suicidal behavior is the result of an interaction between acutely stressful events and a susceptibility to suicidal behavior (a diathesis). This article presents an overview of studies that demonstrate that stress and dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, are important additional risk factors for suicide. Evidence for other putative stress-related suicide risk factors including childhood trauma, impaired executive function, impulsivity and disrupted sleep are considered together with the impact of family history of suicide, perinatal and epigenetic influences on suicide risk.
自杀是一个全球性的健康问题，每年至少造成 80 万人死亡。已经提出了许多模型，它们在强调心理、社会、精神科和神经生物学因素在解释自杀风险方面的作用上有所不同。许多模型的核心是一个应激素质成分，即自杀行为是急性应激事件和对自杀行为的易感性（素质）相互作用的结果。本文概述了一些研究，这些研究表明，应激和下丘脑-垂体-肾上腺（HPA）轴活动的失调，如皮质醇水平所示，是自杀的重要额外风险因素。同时考虑了其他推测的与应激相关的自杀风险因素，包括儿童期创伤、执行功能障碍、冲动和睡眠障碍，以及自杀风险的家族史、围产期和表观遗传影响。
