4.5 Review

The role of inflammation in suicidal behaviour

Journal

ACTA PSYCHIATRICA SCANDINAVICA
Volume 132, Issue 3, Pages 192-203

Publisher

WILEY
DOI: 10.1111/acps.12458

Keywords

suicide; neuroimmunology; neuroendocrinology; neurobiology; glutamate; inflammation; cytokine; kynurenine; asthma; allergy; autoimmunity; traumatic brain injury; infection

Categories

Funding

  1. National Institute of Mental Health, Bethesda, MD [R01MH104622-01]
  2. Michigan State University
  3. Van Andel Research Institute
  4. Swedish Research Council [2009-7052, 2013-2838]
  5. Astra Zeneca
  6. American Foundation for Suicide Prevention Distinguished Investigator Award
  7. Veterans Integrated Service Network 19, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Denver, CO, USA
  8. Veterans Integrated Service Network 5, MIRECC, Baltimore, MD, USA
  9. Mid-Atlantic Nutrition and Obesity Research Center (NORC) from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD [P30DK072488]

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ObjectiveOver the past decade, clinical data have accumulated showing that inflammation might contribute to the pathophysiology of suicide. To evaluate the associations and to identify the support for pathways linking inflammatory processes with suicidal behaviour, a comprehensive review of the literature was undertaken. MethodThe search terms cytokine', risk factors', kynurenine', asthma', allergy', autoimmunity', traumatic brain injury', infection' along with the terms inflammation' and suicide' were entered into PubMed, and a thorough analysis of the publications and their reference lists was performed. ResultsThe effects of inflammation on mood and behaviour could partially be mediated by kynurenine pathway metabolites, modulating neuroinflammation and glutamate neurotransmission. At the same time, the triggers of the inflammatory changes documented in suicidal patients may be attributed to diverse mechanisms such as autoimmunity, neurotropic pathogens, stress or traumatic brain injury. ConclusionTargeting the inflammatory system might provide novel therapeutic approaches as well as potential biomarkers to identify patients at increased risk. For the goal of improved detection and treatment of suicidal individuals to be achieved, we need to develop a detailed understanding of the origin, mechanisms and outcomes of inflammation in suicidal behaviour.

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