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Author Affiliations: Department of Psychiatry and Legal Medicine, Vall d'Hebron University Hospital, Universitat Aut¨°noma de Barcelona, Spain (Braquehais MD, Casas M); Department of Child and Adolescent Psychiatry and Psychology, Sant Joan de Deu Hospital, Universitat de Barcelona, Spain (Picouto MD); Department of Psychiatry, James J. Peters Veterans' Administration Medical Center and Department of Psychiatry, Mount Sinai School of Medicine, New York, USA (Sher L)
Corresponding Author: Mar¨ªa Dolores Braquehais, MD, PhD, Department of Psychiatry and Legal Medicine, Vall d'Hebron University Hospital Universitat Aut¨°noma de Barcelona, Pg. de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain (Tel: +34-93 489 42 94; Fax: +34- 93 489 45 87; Email: mdbraquehais@vhebron.net)
doi:10.1007/s12519-012-0358-0
Background: Biological markers of vulnerability for current or future risk of suicide in adolescents could be important adjuncts to the treatment and prevention of this phenomenon.
Data sources: We conducted a PubMed search of all English-language articles published between January 1990 and June 2011 using the following search terms: ("hypothalamic-pituitary-adrenal" OR "HPA") AND ("adolescence" OR "adolescent" OR "teenager") AND ("depression" OR "major depressive disorder" OR "suicidal behavior" OR "suicidal ideation" OR "suicidal thoughts" OR "deliberate self-harm" OR "suicidal attempt" OR "suicide").
Results: HPA axis activity can be examined using different methods that do not have the same biological interpretation. An abnormal HPA axis functioning together with an anomalous interaction between HPA mechanisms and other systems such as the serotonergic system may be one of the neurobiological correlates of emotion dysregulation (ED). ED may play an important role in adolescent suicidal behavior. Some psychopathological conditions such as depression or childhood psychological trauma that increase suicidal risk in adolescents are also associated with HPA axis dysregulation. ED, a personality trait, can also be viewed as a predisposing factor that augments the vulnerability to suffer from psychiatric conditions.
Conclusions: Correlating HPA axis dysfunction with psychological factors such as ED could lead to a better understanding of the role of HPA abnormalities in adolescent suicide and may enhance preventive and treatment strategies.
Key words: adolescence; hypothalamic-pituitary-adrenal axis; suicide
World J Pediatr 2012;8(3):197-206
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