Biochemical markers

Abstract

Suicide is a complicated phenomenon related with the interaction of several neurobiological changes and psychosocial factors. The previous postmortem and clinical studies have explored neurobiological changes associated with suicide behavior. These suggest that decreased serotonin function and increased hypothalamic-pituitary-adrenal (HPA) axis are associated with suicide behavior. Serotonin dysfunction in individuals with suicidal behavior has been observed as decreased 5-hydroxyindoleacetic acid (5-HIAA) level in the cerebrospinal fluid, blunted prolactin response to fenfluramine challenge studies, and increased number of platelet serotonin 2A receptors. HPA axis dysfunction in those with suicidal behavior has been shown as increased cortisol level and non-suppression cortisol response to the dexamethasone suppression test. In addition, the reduction of cholesterol and BDNF levels in suicide has been observed, and they can be measured in blood, serum, or plasma. It is still a challenge to the field to find both promising and easily assessable neurobiological predictors of suicidal behavior.