4.5 Review

Suicide, neuroinflammation and other physiological alterations

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SPRINGER HEIDELBERG
DOI: 10.1007/s00406-023-01584-z

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Suicide; Neuroinflammation; Suicide attempt; Inflammatory cytokines

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Suicide is a major public health problem worldwide and the second leading cause of death in the 15-29 age group. The present narrative review explores important aspects of suicide, including risk factors and physiological findings that can contribute to understanding this phenomenon. Objective measures, such as increased neuroinflammation, hyperactivity of the hypothalamic-pituitary-adrenal axis, and alterations in serotonin and vitamin D levels, have been found in individuals who have died by suicide. This review highlights the need for multidisciplinary approaches to address suicide and raise awareness of its significance.
Suicide is considered one of the major public health problems worldwide, being the second leading cause of death in the 15-29 age group. It is estimated that every 40s someone in the world commits suicide. The social taboo surrounding this phenomenon as well as the fact that suicide prevention measures currently fail to avoid deaths from this cause, means that more research is needed to understand its mechanisms. The present narrative review on suicide tries to point out several important aspects, such as risk factors or the dynamics of suicide, as well as the current findings in the field of physiology that could offer advances in the understanding of suicide. Subjective measures of risk such as scales and questionnaires are not effective alone, whereas the objective measures can be addressed from physiology. Thus, an increased neuroinflammation in people who take their own lives has been found, with an increase in inflammatory markers such as interleukin-6 and other cytokines in plasma or cerebrospinal fluid. Also, the hyperactivity of the hypothalamic-pituitary-adrenal axis and a decrease in serotonin or in vitamin D levels seems to also be involved. In conclusion, this review could help to understand which factors can trigger an increased risk of dying by suicide, as well as pointing out those alterations that occur in the body when someone attempt to commit suicide or succeeds in taking their own life. There is a need for more multidisciplinary approaches that address suicide to help to raise awareness of the relevance of this problem that causes the death of thousands of people every year.

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