Neurobiological aspects of suicide and suicide attempts in bipolar disorder
Open accessAbstract
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.
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Depressed suicide decedents have fewer brain-projecting noradrenergic neurons in the rostral locus coeruleus and higher β-adrenergic receptor binding in the PFC, consistent with less noradrenergic activity.
“Depressed suicide decedents have fewer brain-projecting noradrenergic neurons in the rostral locus coeruleus and higher β-adrenergic receptor binding in the PFC, both consistent with less noradrenergic activity.”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [126]
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A brain-centric model of suicidal behavior
Mann, J. J., & Rizk, M. M. (2020) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2020.20081224 · Cited by 214 · see citing works
Schaffer, A., Isometsä, E. T., Tondo, L., Moreno, D. H., Sinyor, M., Kessing, L. V., Turecki, G., Weizman, A., Azorin, J.-M., Ha, K., et al. (2015) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415594427 · Cited by 175 · see citing works
Self-citationENIGMA and the individual: Predicting factors that affect the brain in 35 countries worldwide
Thompson, P. M., Andreassen, O. A., Vásquez, A. A., Bearden, C. E., Boedhoe, P. S. W., Brouwer, R. M., Buckner, R. L., Buitelaar, J. K., Bulayeva, K., Cannon, D. M., et al. (2015) · NeuroImage · doi:10.1016/j.neuroimage.2015.11.057 · Cited by 175 · see citing works
Underwood, M. D., Kassir, S. A., Bakalian, M. J., Galfalvy, H., Dwork, A. J., Mann, J. J., & Arango, V. (2018) · Translational Psychiatry · doi:10.1038/s41398-018-0309-1 · Cited by 128 · see citing works
Brain effective connectivity during motor-imagery and execution following stroke and rehabilitation
Bajaj, S., Butler, A. J., Drake, D. F., & Dhamala, M. (2015) · NeuroImage Clinical · doi:10.1016/j.nicl.2015.06.006 · Cited by 126 · see citing works
Schaffer, A., Isometsä, E. T., Azorin, J.-M., Cassidy, F., Goldstein, T., Rihmer, Z., Sinyor, M., Tondo, L., Moreno, D. H., Turecki, G., et al. (2015) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415594428 · Cited by 120 · see citing works
“With regard to personality traits, a number of studies reported higher scores on tests of aggression and hostility among those with BD who attempt suicide (Azorin et al., 2009; Chaudhury et al., 2007; Grunebaum et al., 2006; Michaelis et al., 2004; Rocca et al., 2010; Sher et al., 2006).”
BackgroundResultInfluentialSelf-citationNeurobiological Basis of Increased Risk for Suicidal Behaviour
Wisłowska-Stanek, A., Kołosowska, K., & Maciejak, P. (2021) · Cells · doi:10.3390/cells10102519 · Cited by 115 · see citing works
Modeling suicide in bipolar disorders
Malhi, G. S., Outhred, T., Das, P., Morris, G., Hamilton, A., & Mannie, Z. N. (2018) · Bipolar Disorders · doi:10.1111/bdi.12622 · Cited by 98 · see citing works
Existing and Novel Biological Therapeutics in Suicide Prevention
Griffiths, J. J., Zarate, C. A., & Rasimas, J. J. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.06.012 · Cited by 94 · see citing works
Self-citationIvković, M., Pantović-Stefanović, M., Dunjić-Kostić, B., Jurišić, V., Lačković, M., Totić-Poznanović, S., Jovanović, A. A., & Damjanović, A. (2016) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2016.01.005 · Cited by 89 · see citing works
Pharmacological Treatment of Bipolar Depression: What are the Current and Emerging Options?
Yalın, N., & Young, A. H. (2020) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s245166 · Cited by 47 · see citing works
Bartoli, F., Brita, C. D., Crocamo, C., Clerici, M., & Carrà, G. (2017) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2017.06.008 · Cited by 39 · see citing works
Structural brain abnormalities in patients with type I bipolar disorder and suicidal behavior
Duarte, D. G. G., das Neves, M. D. C. L., Albuquerque, M. R., Turecki, G., Ding, Y., Duran, F., Busatto, G. F., & Corrêa, H. (2017) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2017.04.012 · Cited by 37 · see citing works
Neuro-transcriptomic signatures for mood disorder morbidity and suicide mortality
Jabbi, M., Arasappan, D., Eickhoff, S. B., Strakowski, S. M., Nemeroff, C. B., & Hofmann, H. A. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.05.013 · Cited by 34 · see citing works
Pawlak, J., Dmitrzak‐Węglarz, M., Maciukiewicz, M., Wiłkość-Dębczyńska, M., Leszczyńska-Rodziewicz, A., Zaremba, D., Kapelski, P., & Hauser, J. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.01.010 · Cited by 33 · see citing works
Suicide behavior as a quantitative trait and its genetic background
Pawlak, J., Dmitrzak‐Węglarz, M., Wiłkość-Dębczyńska, M., Szczepankiewicz, A., Leszczyńska-Rodziewicz, A., Zaremba, D., Kapelski, P., Rajewska‐Rager, A., & Hauser, J. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.07.029 · Cited by 33 · see citing works
Investigation of correlations between DNA methylation, suicidal behavior and aging
Jeremian, R., Chen, Y., Luca, V. D., Vincent, J. B., Kennedy, J. L., Zai, C. C. H., & Strauss, J. (2017) · Bipolar Disorders · doi:10.1111/bdi.12466 · Cited by 33 · see citing works
Familial Aggregation and Coaggregation of Suicide Attempts and Comorbid Mental Disorders in Adults
Ballard, E. D., Cui, L., Vandeleur, C. L., Castelao, E., Zarate, C. A., Preisig, M., & Merikangas, K. R. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2019.0248 · Cited by 30 · see citing works
Self-citationUnderstanding suicide: Focusing on its mechanisms through a lithium lens
Malhi, G. S., Das, P., Outhred, T., Irwin, L., Morris, G., Hamilton, A., Lynch, K., & Mannie, Z. N. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.08.036 · Cited by 30 · see citing works
Are suicide risk factors gender specific?
Pawlak, J., Miechowicz, I., Dmitrzak‐Węglarz, M., Szczepankiewicz, A., Zaremba, D., Kapelski, P., Rajewska‐Rager, A., Czerski, P. M., Skibińska, M., & Hauser, J. (2018) · Psychiatria Polska · doi:10.12740/pp/78974 · Cited by 22 · see citing works
Dogan, K. H., Unaldi, M., & Demirci, S. (2016) · Journal of Forensic Sciences · doi:10.1111/1556-4029.13124 · Cited by 18 · see citing works
Fuller‐Thomson, E., West, K. J., & Baiden, P. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.02.030 · Cited by 14 · see citing works
Frontolimbic brain volume abnormalities in bipolar disorder with suicide attempts
Jabbi, M., Weber, W. A., Welge, J. A., Nery, F. G., Tallman, M. J., Gable, A. S., Fleck, D. E., Lippard, E., DelBello, M. P., Adler, C. M., et al. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113516 · Cited by 13 · see citing works
Benedetti, S., Bucciarelli, S., Canestrari, F., Catalani, S., Mandolini, S., Marconi, V., Mastrogiacomo, A. R., Silvestri, R., Tagliamonte, M. C., Venanzini, R., et al. (2014) · Open Journal of Depression · doi:10.4236/ojd.2014.32011 · Cited by 13 · see citing works
Thyroid Hormone Treatment of Mood Disorders
Duval, F. (2018) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-018-0155-z · Cited by 12 · see citing works
Identification of suicide risk in bipolar disorder
López‐Castromán, J., Courtet, P., Baca‐García, E., & Oquendo, M. A. (2014) · Bipolar Disorders · doi:10.1111/bdi.12264 · Cited by 10 · see citing works
Sheth, C. S., Prescot, A. P., Bueler, E., DiMuzio, J. M., Legarreta, M. D., Renshaw, P. F., Yurgelun-Todd, D. A., & McGlade, E. (2018) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2018.04.004 · Cited by 10 · see citing works
Existing and Novel Biological Therapeutics in Suicide Prevention
Griffiths, J. J., Zarate, C. A., & Rasimas, J. J. (2023) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.23021003 · Cited by 9 · see citing works
Self-citationThe role of the Cys23Ser (rs6318) polymorphism of the HTR2C gene in suicidal behavior
González‐Castro, T. B., Hernández‐Díaz, Y., Juárez‐Rojop, I. E., López‐Narváez, M. L., Tovilla‐Zárate, C. A., Rodrı́guez-Pérez, J. M., & Cruz, J. (2017) · Psychiatric Genetics · doi:10.1097/ypg.0000000000000184 · Cited by 9 · see citing works
Suicide prevention and ketamine: insights from computational modeling
Charlton, C. E., Karvelis, P., McIntyre, R. S., & Diaconescu, A. O. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1214018 · Cited by 7 · see citing works
Integrating biobehavioral information to predict mood disorder suicide risk
Jackson, N., & Jabbi, M. (2022) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2022.100495 · Cited by 7 · see citing works
Cigarette smoking and risk of suicide in bipolar disorder: a systematic review
García-Jiménez, J., Gómez-Sierra, F. J., Martínez-Hortelano, A., Moreno-Merino, P., Serrano, B. G., Molero, P., & Gutiérrez-Rojas, L. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1179733 · Cited by 5 · see citing works
Psychoneural reduction revised: The case of suicidality in bipolar disorder
Carls‐Diamante, S., & Atanasova, N. (2024) · European Journal of Neuroscience · doi:10.1111/ejn.16640 · Cited by 5 · see citing works
Pérez-Rodríguez, M. M., Gutierrez, A., & Welch, A. K. (2016) · Springer eBooks · doi:10.1007/978-3-319-26282-6_31 · Cited by 1 · see citing works
Wolfersdorf, M., Purucker, M., & Schneider, B. (2015) · Springer eBooks · doi:10.1007/978-3-662-47765-6_25 · Cited by 1 · see citing works
The Suicide Attempt in an Artificial Neural Network (Self Organizing Map)
(2016) · Journal of Neurology and Psychology · doi:10.13188/2332-3469.1000031 · Cited by 1 · see citing works
Annear, D., & Agius, M. A. (2016) · PubMed · Cited by 1 · see citing works
Experimental Pharmacologic Approaches for the Reduction of Suicidal Ideation and Behavior
Ballard, E. D., Richards, E. M., Ionescu, D. F., Niciu, M. J., Voort, J. V., & Zarate, C. A. (2014) · Springer eBooks · doi:10.1007/978-3-319-09964-4_12
Self-citationEpigenetic Studies of Complex Human Disorders and Aging
Jeremian, R. (2018) · TSpace (University of Toronto)
Neuroimaging Studies of Bipolar Disorder With Suicide Attempts: A Systematic Review
Yu, X., He, Z., Wang, K., Tang, H., Lu, Y., & Hu, J. (2026) · ALPHA PSYCHIATRY · doi:10.31083/ap50801
- Authors
- Mathews, D., Richards, E., Niciu, M., Ionescu, D., Rasimas, J., & Zarate, C.
- Affiliations
- National Institutes of Health (US)
- Venue
- Translational Neuroscience
- Publisher
- Walter de Gruyter GmbH
- Published
- 2013-06-01
- Volume
- 4
- Issue
- 2
- Pages
- 203-216
- ISSN
- 2081-3856 (ISSN-L)
- 2081-6936
- PMC
- PMC3840723
- OpenAlex
- W2046908495
- Cited by
- 39
- References
- 209
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 7 · 2017: 4 · 2016: 6 · 2015: 6 · 2014: 4
- FWCI
- 3.79
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Translational Neuroscience (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 MH999999)
- National Institute of Mental Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- suicide, suicide attempts, bipolar disorder, neurobiology of suicide, neurochemistry, epigenetics, endophenotypes, suicide risk factors, aggression, impulsivity, suicide prevention, molecular targets
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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