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

  • Maurizio Pompili
  • Gianluca Serafini
  • Marco Innamorati
  • Anne Maria Möller-Leimkühler
  • Giancarlo Giupponi
  • Paolo Girardi
  • Roberto Tatarelli
  • David Lester
Original Paper

DOI: 10.1007/s00406-010-0108-z

Cite this article as:
Pompili, M., Serafini, G., Innamorati, M. et al. Eur Arch Psychiatry Clin Neurosci (2010) 260: 583. doi:10.1007/s00406-010-0108-z

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.

Keywords

HPA-axis Suicide behavior Mood disorders Stress DST 5-HT 

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Maurizio Pompili
    • 1
    • 2
  • Gianluca Serafini
    • 1
  • Marco Innamorati
    • 3
  • Anne Maria Möller-Leimkühler
    • 4
  • Giancarlo Giupponi
    • 5
  • Paolo Girardi
    • 1
  • Roberto Tatarelli
    • 1
  • David Lester
    • 6
  1. 1.Department of PsychiatrySant’Andrea HospitalRomeItaly
  2. 2.McLean HospitalHarvard Medical SchoolBelmontUSA
  3. 3.Università Europea di RomaRomeItaly
  4. 4.Department of PsychiatryLudwig-Maximilians-University of MunichMunichGermany
  5. 5.Department of PsychiatryBolzanoItaly
  6. 6.The Richard Stockton College of New JerseyPomonaUSA

Personalised recommendations