Epigenetic Effects of Childhood Adversity in the Brain and Suicide Risk

摘要: With prevalence estimates ranging between 6.4% and 10.1% [–5], major depression ranks first among the most significant causes of disability premature death, thus imposing a continual economic burden on society. For instance, in United States, direct indirect costs are estimated at U.S.$44 billion/year [6]. The greatest loss to our society, however, is associated mortality by suicide related depression. Indeed, it has been that 50% 70% completers will die during an episode [7,8] prospective follow-up studies suggest 7% 15% these patients [–12].Suicide complex problem, which believed result from interaction several different factors [13,14]. psychological personality traits such as impulsivity negative affect [14,15], social [16,17], environmental early-life adversity [–20], genetic [21], neurobiological [22] have proposed induce behavioral alterations, turn may predispose certain individuals develop depressive suicidal behaviors. However, since alone unlikely explain risk, be more readily explained when considering sources variation [23,24].Among risk factors, adversity, particularly childhood sexual abuse (CSA) physical (CPA), one strongest predictors mental disorders [25,26] [18,19]. example, shown CSA with early onset depression, chronic course, severe outcome [–29] but, importantly, 12 times higher odds behaviors [26,30]. Although less consistently, CPA neglect also [19,31]. self-harm [,,–34], ideation [35,36], attempts [,–39]. Moreover, increase severity intensity [35,36,38].