Neurobiological aspects of suicide and suicide attempts in bipolar disorder

Abstract

Suicide and bipolar disorder (BD) are challenging, complex, and intertwined areas of study in contemporary psychiatry. Indeed, BD is associated with the highest lifetime risk for suicide attempt and completion of all the psychiatric conditions. Given that several clinical risk factors for both suicide and BD have been well noted in the literature, exploring the neurobiological aspects of suicide in BD may provide insights into both preventive measures and future novel treatments. This review synthesizes findings regarding the neurobiological aspects of suicide and, when applicable, their link to BD. Neurochemical findings, genes/epigenetics, and potential molecular targets for current or future treatments are discussed. The role of endophenotypes and related proximal and distal risk factors underlying suicidal behavior are also explored. Lastly, we discuss the manner in which preclinical work on aggression and impulsivity may provide additional insights for the future development of novel treatments.

Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder: Part I of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder

“…While other excellent reviews have been published over the years on suicide attempts and deaths in BD (Baethge and Cassidy, 2013; Gonda et al, 2012; Hawton et al, 2005; Malhi et al, 2013; Mathews et al, 2013; Pompili et al, 2013; Yerevanian and Choi, 2013), this paper provides an important contribution to the literature by being an updated review on the topic, and conducting pooled analyses of suicide rates that include large studies that were not part of prior analyses (Novick et al, 2010; Tondo et al, 2003). …”

“…Based on the understanding that the underlying neurobiology of BD is at least partially distinct from other major psychiatric conditions (Anderson et al, 2013; Fillman et al, 2014; Lan et al, 2014), it would be important to examine the neurobiology of suicide attempts and suicide deaths specific to BD samples. Rather than extrapolate findings from the broad literature on neurobiology of suicide that may be relevant to BD (Mathews et al, 2013), we chose to focus on studies specific to BD samples or when subjects with BD comprised the majority of the study population.…”

The Suicide Attempt in an Artificial Neural Network (Self Organizing Map)

“…We know that the BD is the psychiatric condition with a higher risk of suicide and it is likely that it is not possible to investigate and highlight the real risk without the use of biological markers [30]. Some risk factors have been identified as well as different ways to highlight biological markers of suicide have been tried [15,[31][32][33][34][35][36][37][38][39][40].…”

Investigation of correlations between DNA methylation, suicidal behavior and aging

“…Suicidal ideation and completion have also been associated with candidate genes that mediate stress response and neurotransmission, but the small effect sizes of many genetic studies have failed to demonstrate genome‐wide significant effects. Further, low‐to‐moderate concordance of SB in identical twins with BD suggests that SB follows a distinct pattern of heritability from that of the co‐existing affective disorder . Thus, characterizing the clinically heterogeneous phenotype of suicide requires looking beyond DNA and investigating factors that are dynamic throughout the course of the disease state, can be monitored over time, and are mutable in response to pharmacologic treatment.…”