Experimental and Clinical Physiopathology Research Group CTS-1039, Department of Health Sciences, School of Health Sciences, University of Jaén, Campus Universitario Las Lagunillas, 23071, Jaén, Spain.
Eur Arch Psychiatry Clin Neurosci. 2024 Aug;274(5):1037-1049. doi: 10.1007/s00406-023-01584-z. Epub 2023 Mar 13.
Suicide is considered one of the major public health problems worldwide, being the second leading cause of death in the 15-29 age group. It is estimated that every 40s someone in the world commits suicide. The social taboo surrounding this phenomenon as well as the fact that suicide prevention measures currently fail to avoid deaths from this cause, means that more research is needed to understand its mechanisms. The present narrative review on suicide tries to point out several important aspects, such as risk factors or the dynamics of suicide, as well as the current findings in the field of physiology that could offer advances in the understanding of suicide. Subjective measures of risk such as scales and questionnaires are not effective alone, whereas the objective measures can be addressed from physiology. Thus, an increased neuroinflammation in people who take their own lives has been found, with an increase in inflammatory markers such as interleukin-6 and other cytokines in plasma or cerebrospinal fluid. Also, the hyperactivity of the hypothalamic-pituitary-adrenal axis and a decrease in serotonin or in vitamin D levels seems to also be involved. In conclusion, this review could help to understand which factors can trigger an increased risk of dying by suicide, as well as pointing out those alterations that occur in the body when someone attempt to commit suicide or succeeds in taking their own life. There is a need for more multidisciplinary approaches that address suicide to help to raise awareness of the relevance of this problem that causes the death of thousands of people every year.
自杀被认为是全球主要的公共卫生问题之一,是 15-29 岁年龄组人群的第二大主要死因。据估计,世界上每 40 秒就有一人自杀。由于这种现象存在社会禁忌,而且目前的自杀预防措施未能避免此类死因,因此需要更多的研究来了解其机制。本综述尝试指出自杀的几个重要方面,例如风险因素或自杀的动态,以及生理学领域的当前发现,这些发现可能有助于深入了解自杀。单独使用主观风险评估如量表和问卷并不有效,而客观指标可以从生理学方面来解决。因此,发现自杀者的神经炎症增加,血浆或脑脊液中的白细胞介素-6 和其他细胞因子等炎症标志物增加。此外,似乎还涉及到下丘脑-垂体-肾上腺轴的过度活跃和血清素或维生素 D 水平的降低。总之,本综述可以帮助了解哪些因素会引发自杀风险增加,并指出当有人试图自杀或成功自杀时,身体会发生哪些变化。需要采取更多多学科的方法来解决自杀问题,以提高对这一每年导致数千人死亡的问题的重要性的认识。