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Suicide Risk Assessment: Biological Measures 

Suicide Risk Assessment: Biological Measures
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date: 17 August 2019

Predicting suicide is difficult due to the low base rate, even in high-risk groups, and the multi-causal nature of suicidal behaviour. Retrospective and cross-sectional studies have identified a number of biologic abnormalities associated with suicide and suicide attempt. Prospective studies provide estimates of the predictive utility of biologic measures. Here, we review prospective studies of suicidal behaviour and serotonergic, noradrenergic, dopaminergic systems and the hypothalamic–pituitary– adrenocortical (HPA) axis function in mood disorders. The most promising biologic predictors are low CSF (cerebrospinal fluid) 5-hydroxyindoleacetic acid (5-HIAA) and HPA axis dysfunction as demonstrated by dexamethasone non-suppression that are each associated with about 4.5-fold greater risk of suicide.

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