The androgen model of suicide completion

Abstract

Suicide is a devastating public health issue that imposes severe psychological, social, and economic burdens not only for the individuals but also for their relatives, friends, clinicians, and the general public. Among the different suicidal behaviors, suicide completion is the worst and the most relevant outcome. The knowledge of biological etiopathological mechanisms involved in suicide completion is limited. Hitherto, no objective markers, either alone or in combination, can reliably predict who will complete a suicide. However, such parameters are strongly needed to establish and optimize prediction and prevention. We introduce here a novel ideation-to-completion framework in suicide research and discuss the problems of studies aiming at identifying and validating clinically useful markers. The male gender is a specific risk factor for suicide, which suggests that androgen effects are implicated in the transition from suicidal ideation to suicide completion. We present multiple lines of direct and indirect evidence showing that both an increased prenatal androgen load (with subsequent permanent neuroadaptations) and increased adult androgen activity are involved in suicide completion. We also review data arguing that modifiable maternal behavioral traits during pregnancy contribute to the offspring's prenatal androgen load and increase the risk for suicide completion later in life. We conclude that in utero androgen exposure and adult androgen levels facilitate suicide completion in an synergistic manner. The androgen model of suicide completion provides the basis for the development of novel predictive and preventive strategies in the future.

Lower digit ratio (2D:4D) in alcohol dependence: Confirmation and exploratory analysis in a population‐based study of young men

“…A recent national‐level study revealed a positive correlation between male 2D:4D and life expectancy (after normalization to the national mean of males and females), which suggests that lower 2D:4D is associated with lower life expectancy . Lower 2D:4D relates to a number of causes of deaths relevant to young males such as aggression‐related injuries and suicide . Thus, the positive correlation between R2D:4D and age observed here might support a reduced life expectancy in individuals with lower R2D:4D.…”

GABAA Receptor Subunit Transcriptional Regulation, Expression Organization, and Mediated Calmodulin Signaling in Prefrontal Cortex of Rats Showing Testosterone-Mediated Impulsive Behavior

“…From a clinical perspective, GABA A receptors are more frequently used as therapeutic targets when treating disorders such as anxiety and epilepsy (Arin et al, 2018). In the future, it will be interesting to translate this study to a human level to examine if GABA receptor functions are altered during impulsivity, particularly in suicidal people where this interaction has been shown to play a critical role in attempted and completed suicide (Sher et al, 2017;Lenz et al, 2019). There were a few limitations to our study.…”

Digit ratio (2D:4D) and transgender identity: new original data and a meta-analysis

“…This study investigated a possible association of 2D:4D and transsexuality in a large sample. It was part of the Finger Length in Psychiatry (FLIP) project 13 , 20 – 27 , a line of independent studies aiming to elucidate the role of prenatal sex hormone organization in the etiopathogenesis of psychiatric disorders in childhood, adolescence, and adulthood, such as addictive disorders 22 , 26 , 28 , 29 , 30 , suicide completion 31 , or behavioral symptoms in children 32 . Another goal was to establish prevention targets and strategies based on this model 33 .…”