BACKGROUND There has been increasing interest in both suicide-specific diagnoses within the psychiatric nomenclature and related biomarkers. Because the Suicide Crisis Syndrome-an emotional crescendo of several interrelated symptoms-seems to be promising for the identification of individuals at risk of suicide, the aim of the present paper is to review the putative biological underpinnings of the Suicide Crisis Syndrome symptoms (entrapment, affective disturbance, loss of cognitive control, hyperarousal, social withdrawal). METHODS A PubMed literature search was performed to identify studies reporting a link between each of the 5 Suicide Crisis Syndrome symptoms and biomarkers previously reported to be associated with suicidal outcomes. RESULTS Disturbances in the hypothalamic-pituitary-adrenal axis, with dysregulated corticotropin-releasing hormone and cortisol levels, may be linked to a sense of entrapment. Affective disturbance is likely mediated by alterations in dopaminergic circuits involved in reward and antireward systems as well as endogenous opioids. Loss of cognitive control is linked to altered neurocognitive function in the areas of executive function, attention, and decision-making. Hyperarousal is linked to autonomic dysregulation, which may be characterized by a reduction in both heart rate variability and electrodermal activity. Social withdrawal has been associated with oxytocin availability. There is also evidence that inflammatory processes may contribute to individual Suicide Crisis Syndrome symptoms. CONCLUSION The Suicide Crisis Syndrome is a complex syndrome that is likely the consequence of distinct changes in interconnected neural, neuroendocrine, and autonomic systems. Available clinical and research data allow for development of empirically testable hypotheses and experimental paradigms to scrutinize the biological substrates of the Suicide Crisis Syndrome.

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自杀危机综合症候选生物标志物：接下来要测试什么？概念文件。

背景技术对精神科术语内的自杀特异性诊断和相关生物标志物的兴趣日益增加。由于自杀危机综合症-一种相互关联的症状的情绪渐增-有望用于确定有自杀风险的个体，因此本论文的目的是审查自杀危机综合症症状的假定生物学基础（诱因，情感障碍，失去认知控制，情绪亢进，社交退缩）。方法进行PubMed文献检索，以鉴定报告5种自杀危机综合症症状中的每一种症状与先前报道与自杀结果相关的生物标志物之间存在关联的研究。结果下丘脑-垂体-肾上腺轴紊乱，促肾上腺皮质激素释放激素和皮质醇水平失调可能与压迫感有关。情感障碍很可能是由参与奖励和抗奖励系统的多巴胺能回路以及内源性阿片样物质引起的。认知控制的丧失与执行功能，注意力和决策方面的神经认知功能改变有关。过度兴奋与自主神经调节异常有关，自主神经调节异常可能以心率变异性和皮肤电活动降低为特征。社交退缩与催产素的可获得性有关。也有证据表明，炎症过程可能会导致个体自杀危机综合症的症状。结论自杀危机综合症是一种复杂的综合症，可能是相互连接的神经系统，神经内分泌系统和自主系统发生明显变化的结果。现有的临床和研究数据可用于开发经验可检验的假设和实验范式，以审查自杀危机综合症的生物底物。