Suicidal ideation pathophysiology: Difference between revisions

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{{Suicidal ideation}}


{{CMG}}; {{AE}} {{Vbe}}
==Overview==
It is thought that [[suicidal]] ideation is caused by decreased expression of [[serotonin]] transporter [[gene]], studies have shown that there is decreased expression of 5 HTT(SLC6A4 gene) in [[Prefrontal cortex|prefronta]]<nowiki/>l and [[Cortical T ALL|cortical]] region. [[MAO-A|MAO]] and [[MAOB]] have also been implicated.
==Pathophysiology==
Decreased [[cerebrospinal fluid]] (CSF) [[serotonin]] levels and [[serotonin]] receptor dysfunction are strong risk factors for [[suicide attempt]] and completion. Dysfunction in central [[serotonin]] systems is associated with a lowered threshold for self-directed and externally directed aggressive behavior. In 1976, As berg et al reported a bi-modal distribution of serotonin metabolites (5-HIAA) in the CSF of [[Depressed mood|depressed]] patients.In this study, significantly more of the [[Depressed mood|depressed]] patients in the "low" CSF 5-HIAA group had attempted [[suicide]] compared to the "high" CSF group. A five-year follow-up study of [[Depressed Mood|depressed]] patients concluded that patients who attempted [[suicide]] before the index admission and who reattempted suicide during the follow-up had significantly lower CSF levels of [[5-HIAA]].To date, more than 20 studies have reported low concentrations of CSF 5-HIAA in suicide attempters with a broad range of diagnoses, making this one of the strongest findings in biological [[psychiatry]]. The absolute reduction in the concentration of CSF 5-HIAA appears to correlate well with lethality, increased planning, and medical damage of the suicide attempt.The [[pharmacotherapy]] of [[suicidal]] patients often aims at increasing [[serotonin]] availability in the [[brain stem]].
==Genetics==
*[[Genes]] involved in the [[pathogenesis]] of [[suicidal]] ideation include SKA 2 DNA [[methylation]], which has been seen in multiple cohorts. <ref name="pmid26305478">{{cite journal |vauthors=Kaminsky Z, Wilcox HC, Eaton WW, Van Eck K, Kilaru V, Jovanovic T, Klengel T, Bradley B, Binder EB, Ressler KJ, Smith AK |title=Epigenetic and genetic variation at SKA2 predict suicidal behavior and post-traumatic stress disorder |journal=Transl Psychiatry |volume=5 |issue= |pages=e627 |year=2015 |pmid=26305478 |pmc=4564560 |doi=10.1038/tp.2015.105 |url=}}</ref>
==Associated Conditions==
The following conditions are associated with increased risk of [[suicidal]] ideation:
** [[ Major depressive disorder]]
**[[Bipolar disorder]]
**[[Schizophrenia]]
**[[Post traumatic stress disorder]]
**[[Anxiety]]
**[[Personality disorders]]
==References==
{{Reflist|2}}
{{WH}}
{{WS}}

Latest revision as of 04:13, 3 January 2021