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Abstract
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This second volume of our Research Topic ties in with the previous one spotlighting most important issues in emergency psychiatry: suicidality, coercive measures and coping of psychological challenges for health care providers.
Suicidality is without doubt one of the most alerting and urgent symptomatology in mental health. More than 700,000 people worldwide die by suicide every year, and the number of suicide attempts (SA) is estimated as 20-times higher (1). While risk factors for suicidal behavior such as childhood maltreatment, non-suicidal self-injury, and previous SA have been identified across psychiatric disorders (2, 3), up to 70% of suicides have been linked to affective disorders (4). Since the knowledge of suicide predictors has shown limited effect reducing suicide risk in clinical practice over the years according to a recent meta-analysis (5), we still need to improve our understanding of the neurobiology, contributing psychosocial factors and efficient clinical approaches of suicidality. With respect to these needs, dysregulation of the stress hormone system, namely the hypothalamic-pituitary-adrenocortical (HPA) axis, is one of the most consistent neurobiological findings in both, major depression and suicidality. Interestingly, Hennings et al. show that previous SA--which is also an important clinical suicide risk factor--not only have an attenuating effect on the HPA axis activity during a depressive episode but also impact on the recovery of altered HPA axis reactivity due to depression indicating both, acute effects on HPA axis as well as persistent alteration on stress hormone regulation related to a history of suicide attempts.
Language: en |