- Section 1 The Subject Matter of and Approach to Psychiatry
- 1.3 Psychiatry as a worldwide public health problem
- 1.4 The history of psychiatry as a medical specialty
- 1.5 Ethics and values
- 1.6 The psychiatrist as a manager
- 1.7 Descriptive phenomenology
- 1.8 Assessment
- 1.9 Diagnosis and classification
- 1.10 From science to practice
- Section 2 The Scientific Basis of Psychiatric Aetiology
- 2.3 The contribution of neurosciences
- 2.4 The contribution of genetics
- 2.5 The contribution of psychological science
- 2.6 The contribution of social sciences
- 2.7 The contribution of epidemiology to psychiatric aetiology
- Section 3 Psychodynamic Contributions to Psychiatry
- Section 4 Clinical Syndromes of Adult Psychiatry
- 4.4 Persistent delusional symptoms and disorders
- 4.5 Mood disorders
- 4.6 Stress-related and adjustment disorders
- 4.7 Anxiety disorders
- 4.7.1 Generalized anxiety disorders
- 4.7.2 Social anxiety disorder and specific phobias
- 4.7.3 Panic disorder and agoraphobia
- 4.8 Obsessive–compulsive disorder
- 4.9 Depersonalization disorder
- 4.10 Disorders of eating
- 4.11 Sexuality, gender identity, and their disorders
- 4.12 Personality disorders
- 4.13 Habit and impulse control disorder
- 4.14 Sleep–wake disorders
- 4.15 Suicide
- 4.15.1 Epidemiology and causes of suicide
- 4.15.2 Deliberate self-harm: epidemiology and risk factors
- 4.15.3 Biological aspects of suicidal behaviour
- 4.15.4 Treatment of suicide attempters and prevention of suicide and attempted suicide
- 4.16 Culture-related specific psychiatric syndromes
- Section 5 Psychiatry and Medicine
- Section 6 Treatment Methods in Psychiatry
- 6.2 Somatic treatments
- Section 7 Social Psychiatry and Service Provision
- Section 8 The Psychiatry of Old Age
- Section 9 Child and Adolescent Psychiatry
Biological aspects of suicidal behaviour
- Chapter:
- Biological aspects of suicidal behaviour
- Author(s):
J. John Mann
and Dianne Currier
- DOI:
- 10.1093/med/9780199696758.003.0123
To understand the biological underpinnings of multi-determined behaviours such as suicide and attempted suicide it is necessary to situate them within an explanatory model that can elaborate the causal pathways and interrelations between biological, clinical, genetic, and environmental factors that all play a role in suicidal behaviour. Where possible, such a model should be clinically explanatory, incorporate biological correlates, be testable in both clinical and biological studies, and have some utility in identifying high-risk individuals. We have proposed a stress–diathesis model of suicidal behaviour wherein exposure to a stressor precipitates a suicidal act in those with the diathesis, or propensity, for suicidal behaviour. Stressors are generally state-dependent factors such as an episode of major depression or adverse life event. The diathesis, we have hypothesized, comprises trait characteristics such as impulsive aggression, and pessimism. Uncovering the biological mechanisms relevant to the stress and the diathesis dimensions of suicidal behaviour will facilitate the identification of both enduring and proximal markers of risk, as well as potential targets for treatment. One biological correlate of the diathesis for suicidal behaviour appears to be low serotonergic activity. Abnormal serotonergic function may be the result of numerous factors including genetics, early life experience, chronic medical illness, alcoholism or substance use disorder, many of which have been correlated with increased risk for suicidal behaviour. Moreover, serotonergic dysfunction may underlie recurrent mood disorders or behavioural traits that characterize the diathesis, such as aggression and impulsivity. In terms of stress response, the noradrenergic and HPA axis have been the focus of biological studies in suicidal behaviour. This chapter gives an overview of the major neurobiological findings in suicide and attempted suicide, as well as emerging findings from studies of genes related to those systems.
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- Section 1 The Subject Matter of and Approach to Psychiatry
- 1.3 Psychiatry as a worldwide public health problem
- 1.4 The history of psychiatry as a medical specialty
- 1.5 Ethics and values
- 1.6 The psychiatrist as a manager
- 1.7 Descriptive phenomenology
- 1.8 Assessment
- 1.9 Diagnosis and classification
- 1.10 From science to practice
- Section 2 The Scientific Basis of Psychiatric Aetiology
- 2.3 The contribution of neurosciences
- 2.4 The contribution of genetics
- 2.5 The contribution of psychological science
- 2.6 The contribution of social sciences
- 2.7 The contribution of epidemiology to psychiatric aetiology
- Section 3 Psychodynamic Contributions to Psychiatry
- Section 4 Clinical Syndromes of Adult Psychiatry
- 4.4 Persistent delusional symptoms and disorders
- 4.5 Mood disorders
- 4.6 Stress-related and adjustment disorders
- 4.7 Anxiety disorders
- 4.7.1 Generalized anxiety disorders
- 4.7.2 Social anxiety disorder and specific phobias
- 4.7.3 Panic disorder and agoraphobia
- 4.8 Obsessive–compulsive disorder
- 4.9 Depersonalization disorder
- 4.10 Disorders of eating
- 4.11 Sexuality, gender identity, and their disorders
- 4.12 Personality disorders
- 4.13 Habit and impulse control disorder
- 4.14 Sleep–wake disorders
- 4.15 Suicide
- 4.15.1 Epidemiology and causes of suicide
- 4.15.2 Deliberate self-harm: epidemiology and risk factors
- 4.15.3 Biological aspects of suicidal behaviour
- 4.15.4 Treatment of suicide attempters and prevention of suicide and attempted suicide
- 4.16 Culture-related specific psychiatric syndromes
- Section 5 Psychiatry and Medicine
- Section 6 Treatment Methods in Psychiatry
- 6.2 Somatic treatments
- Section 7 Social Psychiatry and Service Provision
- Section 8 The Psychiatry of Old Age
- Section 9 Child and Adolescent Psychiatry