“Imagine having a disease that we knew killed almost a million people a year, a quarter of them before the age of thirty, and yet we knew nothing about why some individuals are more vulnerable to this disease,” said Dr Anne-Laura van Harmelen, co-first author from the University of Cambridge.The first of these networks involves areas towards the front of the brain known as the medial and lateral ventral prefrontal cortex and their connections to other brain regions involved in emotion. Alterations in this network may lead to excessive negative thoughts and difficulties regulating emotions, stimulating thoughts of suicide.
The second network involves regions known as the dorsal prefrontal cortex and inferior frontal gyrus system. Alterations in this network may influence suicide attempt, in part, due to its role in decision making, generating alternative solutions to problems, and controlling behaviour.
The researchers suggest that if both networks are altered in terms of their structure, function or biochemistry, this might lead to situations where an individual thinks negatively about the future and is unable to control their thoughts, which might lead to situations where an individual is at higher risk for suicide.
The majority of studies so far have been cross-sectional, meaning that they take a ‘snapshot’ of the brain, rather than looking over a period of time, and so can only relate to suicidal thoughts or behaviours in the past. The researchers say there is an urgent need for more research that looks at whether their proposed model relates to future suicide attempts and at whether any therapies are able to change the structure or function of these brain networks and thereby perhaps reduce suicide risk.
The review highlighted the paucity of research into suicide, particularly into sex differences and among vulnerable groups. Despite suicidal thoughts often first occurring as early as during adolescence, the majority of studies focused on adults.
Even more striking, despite the fact that transgender individuals are at increased risk for suicide, just one individual in the 131 samples included for the review was identified to be transgender.
“There are very vulnerable groups who are clearly not being served by research for a number of reasons, including the need to prioritise treatment, and reduce stigma,” said van Harmelen. “We urgently need to study these groups and find ways to help and support them.”
In 2018, the researchers launched the HOPES (Help Overcome and Prevent the Emergence of Suicide) study, supported by the mental health research charity MQ. HOPES brings together data from around 4,000 young people across 15 different countries in order to develop a model to predict who is at risk of suicide. Over the course of the project, the team will analyse brain scans, information on young people’s environment, psychological states and traits in relation to suicidal behaviour from young people from across the world, to identify specific, universal risk-factors.
source: Healthnews
