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European Archives of Psychiatry and Clinical Neuroscience
Published in: European Archives of Psychiatry and Clinical Neuroscience 8/2010

01-12-2010 | Original Paper

The hypothalamic-pituitary-adrenal axis and serotonin abnormalities: a selective overview for the implications of suicide prevention

Authors: Maurizio Pompili, Gianluca Serafini, Marco Innamorati, Anne Maria Möller-Leimkühler, Giancarlo Giupponi, Paolo Girardi, Roberto Tatarelli, David Lester

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 8/2010

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Abstract

Suicidal behavior and mood disorders are one of the world’s largest public health problems. The biological vulnerability for these problems includes genetic factors involved in the regulation of the serotonergic system and stress system. The hypothalamic-pituitary-adrenal (HPA) axis is a neuroendocrine system that regulates the body’s response to stress and has complex interactions with brain serotonergic, noradrenergic and dopaminergic systems. Corticotropin-releasing hormone and vasopressin act synergistically to stimulate the secretion of ACTH that stimulates the biosynthesis of corticosteroids such as cortisol from cholesterol. Cortisol is a major stress hormone and has effects on many tissues, including on mineralocorticoid receptors and glucocorticoid receptors in the brain. Glucocorticoids produce behavioral changes, and one important target of glucocorticoids is the hypothalamus, which is a major controlling center of the HPA axis. Stress plays a major role in the various pathophysiological processes associated with mood disorders and suicidal behavior. Serotonergic dysfunction is a well-established substrate for mood disorders and suicidal behavior. Corticosteroids may play an important role in the relationship between stress, mood changes and perhaps suicidal behavior by interacting with 5-HT1A receptors. Abnormalities in the HPA axis in response to increased levels of stress are found to be associated with a dysregulation in the serotonergic system, both in subjects with mood disorders and those who engage in suicidal behavior. HPA over-activity may be a good predictor of mood disorders and perhaps suicidal behavior via abnormalities in the serotonergic system.
Footnotes
1
Isolated cells from different tissues, kept in cultures, maintain a cyclical pattern of their biochemical activities.
 
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Metadata
Title
The hypothalamic-pituitary-adrenal axis and serotonin abnormalities: a selective overview for the implications of suicide prevention
Authors
Maurizio Pompili
Gianluca Serafini
Marco Innamorati
Anne Maria Möller-Leimkühler
Giancarlo Giupponi
Paolo Girardi
Roberto Tatarelli
David Lester
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
European Archives of Psychiatry and Clinical Neuroscience / Issue 8/2010
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-010-0108-z

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