Leo Sher, M.D.

A review article, “The role of inflammation in the pathophysiology of depression and suicidal behavior: Implications for treatment” was published in the January 2023 issue of Medical Clinics of North America (1).

Depression and suicidal behavior are complex psychiatric conditions of significant public health concerns due to their debilitating nature. The need to enhance contemporary treatments and preventative approaches for these illnesses not only calls for refinement of current views of their pathogenesis but also provides an impetus for further elucidation of their etiological determinants.

Inflammation has been recognized as a potentially important contributor to the development of depression and suicidal behavior. This review highlights key evidence that supports the presence of dysregulated neurometabolic and immunologic signaling and abnormal interaction with microbial species as putative etiological hallmarks of inflammation in depression as well as their contribution to the development of suicidal behavior. Various ideas regarding the immunologic etiology of depression have been proposed, including the immunosuppression and sickness behavior theories, and most recently, the implication of myeloid cell-mediated hyperinflammation. It is important to note that inflammatory pathology is not unique for depression and suicidal behavior, as elevated levels of inflammatory cytokines have been noted in other psychiatric diseases. Furthermore, therapeutic insights addressing candidate mechanisms of pathological inflammation in these disorders are proposed in this review paper. A pathway-specific approach to inhibit pathological inflammation is reasonable to improve the effectiveness of treatment and suicide prevention in psychiatric illnesses.

Reference

1. Serafini G, Costanza A, Aguglia A, Amerio A, Trabucco A, Escelsior A, Sher L, Amore M. The role of inflammation in the pathophysiology of depression and suicidal behavior: Implications for treatment. Med Clin North Am. 2023 Jan;107(1):1-29. doi: 10.1016/j.mcna.2022.09.001.