A Brain-Centric Model of Suicidal Behavior

Mann, J. John; Rizk, Mina

doi:10.1176/appi.ajp.2020.20081224

Cited by 122 publications

(102 citation statements)

References 295 publications

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“…Furthermore, a correlation between peripheral dysfunctions of serotoninergic transmission, assessing metabolic, such as cholesterol and triglycerides, and hematologic, such as platelet-lymphocyte ratio and mean platelet volume, parameters and HLSA was demonstrated by recent findings (55,56). A very recent review on the complex phenomenon of suicidal behaviors, conducted by Mann et al (67) confirmed these findings and concluded that there is deficient serotonin release in HLSA. This is not likely due to serotonin biosynthesis, but seems to be associated with up-regulated serotonin 1A (5-HT 1A ) auto-receptors located on serotonin neuron cell bodies and proximal dendrites (70) or postsynaptic cortical serotonin 2A receptors (5-HT 2A ) that correlate with lifetime aggression severity (71).…”

Section: Discussionmentioning

confidence: 91%

“…Furthermore, suicide attempters with familiarity for suicidal behavior reported smaller volumes in temporal regions, dorso-lateral pre-frontal cortex, and putamen. These cerebral structures play a role in cognitive process like decision making, inhibition, emotional dysregulation, and risk perception, and when compromised because of several factors (i.e., heat, climate change, sleep-deficiency), they could lead to more impulsive decisions and acts ( 67 ). Lastly, based on the assumption that similar areas of the insular cortex are activated during recall of feelings and sensation of pain and temperature ( 68 ), we assumed a link between the perception of significant heat and emotional correlation of discomfort, which could lead to suicidal behaviors in subjects at risk.…”

Section: Discussionmentioning

confidence: 99%

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Meteorological Variables and Suicidal Behavior: Air Pollution and Apparent Temperature Are Associated With High-Lethality Suicide Attempts and Male Gender

et al. 2021

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This study analyzed the impact of meteorological variables and high-lethality suicide attempts (HLSA) to assess a potential time shift of HLSA affected by climate evolution to predict the suicide attempt cases over different periods of the year. After attempting suicide, 225 subjects were admitted to the emergency ward of the IRCCS Ospedale Policlinico San Martino and later to the psychiatric unit from March 2016 to July 2018. Socio-demographic and clinical characteristics as well as the meteorological variables were collected. The Mann-Kendall test as well as redundancy and cross-correlation analyses were performed to analyze the trends, statistically correlations, and correspondence of the trends, respectively between suicidal behaviors and climatic factors. Sixty-seven (29.8%) committed a HLSA. Our findings indicate a significant association between HLSA and male gender and apparent temperature with a strong correlation of 75% with a phase shift of −1 month. Solar radiation and air pollution (PM2.5) have a positive correlation of 65 and 32%, respectively, with a zero-time lag. Limitations include that the data are limited to a single hospital; psychological factors, or other clinical variables that could be ruled out as a trigger have not been considered. Meteorological variables may not mirror the temperature that the patient is exposed to due to the air conditioning systems. Exploring those environmental factors associated with HLSA in a more detailed manner could lead to early intervention and prevention strategies for such distressing admissions.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Meteorological Variables and Suicidal Behavior: Air Pollution and Apparent Temperature Are Associated With High-Lethality Suicide Attempts and Male Gender

et al. 2021

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“…Alcohol and suicide also share a number of distal, predisposing risk factors that may interact with immediate, proximal factors to produce suicidal outcomes. For example, according to the stress-diathesis model of suicidal behavior [ 39 , 40 ], alcohol use might trigger suicidal behavior in those with an underlying vulnerability, such as a propensity toward stress-reactive impulsivity. Externalizing traits in particular may reflect an underlying vulnerability that promotes both impulsive aggression and suicidal behavior [ 41 ], and might also dispose an individual toward alcohol misuse [ 42 , 43 ].…”

Section: Alcoholmentioning

confidence: 99%

Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders

Rizk

Herzog

Dugad³

et al. 2021

Curr Addict Rep

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Purpose of Review Suicide is a major public health concern and a leading cause of death in the US. Alcohol and opioid use disorders (AUD/OUD) significantly increase risk for suicidal ideation, attempts, and death, and are the two most frequently implicated substances in suicide risk. We provide a brief overview of shared risk factors and pathways in the pathogenesis of AUD/OUD and suicidal thoughts and behaviors. We also review clinical recommendations on inpatient care, pharmacotherapy, and psychotherapeutic interventions for people with AUD/OUD and co-occurring suicidal ideation and behavior. Recent Findings Among people with an underlying vulnerability to risk-taking and impulsive behaviors, chronic alcohol intoxication can increase maladaptive coping behaviors and hinder self-regulation, thereby increasing the risk of suicide. Additionally, chronic opioid use can result in neurobiological changes that lead to increases in negative affective states, jointly contributing to suicide risk and continued opioid use. Despite significantly elevated suicide risk in individuals with AUD/OUD, there is a dearth of research on pharmacological and psychosocial interventions for co-occurring AUD/OUD and suicidal ideation and behavior. Summary Further research is needed to understand the effects of alcohol and opioid use on suicide risk, as well as address notable gaps in the literature on psychosocial and pharmacological interventions to lower risk for suicide among individuals with AUD/OUD.

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“…Many scientists have suggested that suicidal thoughts (i.e., thoughts related to desire for death or suicide, regardless of suicidal intent) and behaviors (i.e., suicide attempt with nonzero intent; death by suicide; Silverman et al, 2007) are partially the result of differences or abnormalities in neurobiological systems (Joiner et al, 2005; Mann, 2003; Van Heeringen & Mann, 2014). Specifically, most of these neurobiological models of suicide suggest that suicide is the result of an interaction between dynamic, contextual factors (e.g., stress) and static factors (e.g., genetic loading for suicidal behavior that is independent of mental disorders; Mann, 2003, 2003; Mann & Rizk, 2020; Van Heeringen & Mann, 2014). Variations in genetic loading, these models argue, play an important role in the development of the structure and function of neural circuits, such as in the hypothalamic-pituitary-adrenal axis or in the serotonergic projections throughout the brain (Mann & Rizk, 2020).…”

mentioning

confidence: 99%

Suicidal Thoughts, Behaviors, and Event-Related Potentials: A Systematic Review and Meta-Analysis

Gallyer

Dougherty

Burani

et al. 2020

Preprint

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Suicidal thoughts and behaviors (STBs) are thought to be the result, at least in part, of abnormalities in various neural systems. Event-related potentials (ERPs) are a useful method for studying neural activity, and can be leveraged to study neural deficits related to STBs, but it is unknown how effective ERPs are at differentiating various STB groups. The present metaanalysis examined how well ERPs can differentiate those with and without suicidal ideation (SI), suicide attempts (SA), and those determined to be at different levels of suicide risk, or suicidality. Our meta-analysis included 192 effect sizes from 24 studies. We used a random effects meta-analysis and found a small-to-moderate relationship between ERPs and STBs.However, we also found evidence that the literature may be suffering from small sample publication bias. Our results suggest that ERPs may compliment other approaches, such as fMRI, in the study of the neurobiology of individuals with STBs. However, the clinical utility of ERPs to predict STBs remains to be tested, and larger samples are needed to confirm the results of the present meta-analysis.

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A Brain-Centric Model of Suicidal Behavior

Cited by 122 publications

References 295 publications

Meteorological Variables and Suicidal Behavior: Air Pollution and Apparent Temperature Are Associated With High-Lethality Suicide Attempts and Male Gender

Meteorological Variables and Suicidal Behavior: Air Pollution and Apparent Temperature Are Associated With High-Lethality Suicide Attempts and Male Gender

Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders

Suicidal Thoughts, Behaviors, and Event-Related Potentials: A Systematic Review and Meta-Analysis

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