{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:51:40Z","timestamp":1790833900442,"version":"4.1.0"},"reference-count":162,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T00:00:00Z","timestamp":1574985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001455","name":"American Foundation for Suicide Prevention","doi-asserted-by":"publisher","award":["RFA-1-015-14"],"award-info":[{"award-number":["RFA-1-015-14"]}],"id":[{"id":"10.13039\/100001455","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There has been increasing interest in both suicide-specific diagnoses within the psychiatric nomenclature and related biomarkers. Because the Suicide Crisis Syndrome\u2014an emotional crescendo of several interrelated symptoms\u2014seems 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ijnp\/pyz063","type":"journal-article","created":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T15:11:19Z","timestamp":1574867479000},"page":"192-205","source":"Crossref","is-referenced-by-count":58,"title":["Candidate Biomarkers of Suicide Crisis Syndrome: What to Test Next? A Concept Paper"],"prefix":"10.1093","volume":"23","author":[{"given":"Raffaella","family":"Calati","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Mount Sinai Beth Israel, New York, New York"},{"name":"Icahn School of Medicine at Mount Sinai, New York, New York"},{"name":"Department of Psychology, University of Milan-Bicocca, Milan, Italy"},{"name":"Department of Adult Psychiatry, N\u00eemes University Hospital, N\u00eemes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles B","family":"Nemeroff","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Texas Dell Medical School, Austin, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Lopez-Castroman","sequence":"first","affiliation":[{"name":"Department of Adult Psychiatry, N\u00eemes University Hospital, N\u00eemes, France"},{"name":"INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa J","family":"Cohen","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Mount Sinai Beth Israel, New York, New York"},{"name":"Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Galynker","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Mount Sinai Beth Israel, New York, New York"},{"name":"Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,11,29]]},"reference":[{"key":"2020042107554725400_CIT0001","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/S0272-7358(00)00057-X","article-title":"Paradoxical effects of thought suppression: a meta-analysis of controlled studies","volume":"21","author":"Abramowitz","year":"2001","journal-title":"Clin Psychol Rev"},{"key":"2020042107554725400_CIT0002","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jad.2018.09.010","article-title":"White matter - emotion processing activity relationships in youth offspring of bipolar parents","volume":"243","author":"Acuff","year":"2019","journal-title":"J Affect Disord"},{"key":"2020042107554725400_CIT0003","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1007\/s11920-016-0736-8","article-title":"A slice of the suicidal brain: what have postmortem molecular studies taught us?","volume":"18","author":"Almeida","year":"2016","journal-title":"Curr Psychiatry Rep"},{"key":"2020042107554725400_CIT0004","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"2013","edition":"5th ed"},{"key":"2020042107554725400_CIT0005","first-page":"131","article-title":"Serotonin receptor subtype and p11 mRNA expression in stress-relevant brain regions of suicide and control subjects","volume":"33","author":"Anisman","year":"2008","journal-title":"J Psychiatry Neurosci"},{"key":"2020042107554725400_CIT0006","first-page":"18","article-title":"Should assessment for bipolar disorder and mixed affective state be a standard part of assessment for suicide risk?","volume":"28","author":"Annear","year":"2016","journal-title":"Psychiatr Danub"},{"key":"2020042107554725400_CIT0007","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1001\/jamapsychiatry.2018.4600","article-title":"Toward an improved understanding of anhedonia","volume":"76","author":"Auerbach","year":"2019","journal-title":"JAMA Psychiatry"},{"key":"2020042107554725400_CIT0008","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1037\/a0030371","article-title":"Quantifying the impact of recent negative life events on suicide attempts","volume":"122","author":"Bagge","year":"2013","journal-title":"J Abnorm Psychol"},{"key":"2020042107554725400_CIT0009","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jad.2014.04.010","article-title":"Near-term predictors of the intensity of suicidal ideation: an examination of the 24 h prior to a recent suicide attempt","volume":"165","author":"Bagge","year":"2014","journal-title":"J Affect Disord"},{"key":"2020042107554725400_CIT0010","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jad.2014.03.027","article-title":"Increased fear-potentiated startle in major depressive disorder patients with lifetime history of suicide attempt","volume":"162","author":"Ballard","year":"2014","journal-title":"J Affect Disord"},{"key":"2020042107554725400_CIT0011","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1080\/15622975.2016.1181783","article-title":"Biological markers for anxiety disorders, OCD and PTSD - a consensus statement. 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