Eduardo J. Aguilar, Samuel G. Siris and Enrique Baca-García
Hospital de Sagunt, Sagunto (Valencia), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Zucker-Hillside Hospital, North Shore – Long Island Jewish Health System. Glen Oaks, New York, USA; Universidad Autonoma de Madrid, Madrid, Spain; Columbia University, New York, New York, USA
War and Suicide. Hauppauge, New York: Nova Science Publishers, 2009, 306 pages.
Suicide and stress are intimately related. The stress-diathesis model is today the best framework to start to understand the complex mechanisms interacting throughout this relationship. The serotonin and stress systems are also closely related and, together with genetic mechanisms, constitute key biological underpinnings of suicide. Environmental factors interact with these gene and biochemical mechanisms in a lifelong process that may end up in suicidal ideation and behavior. Childhood adverse experiences and proximal life events have been shown to respectively predispose and trigger suicidality. Mental disorders are the strongest predictors for suicide. Although affective disorders and alcoholism are particularly linked to suicide, stress-related mechanisms may also play a role in other disorders. In particular, post-traumatic stress disorder is a well-defined stress syndrome potentially associated to suicide. It is therefore an interesting condition when trying to clarify the relationship between stress and suicide. Neuroimaging and physiological studies centered on suicidal behavior occurring in patients diagnosed of diverse pathological conditions are needed. A better understanding of the role of stress in such conditions will also be helpful to disentangle the biological basis of suicide and to develop more effective prevention strategies. This chapter will approach these concepts by reviewing the level of evidence of each element pertaining to the stress-diathesis model applied to suicide.