The role of serotonin in adolescent suicide: theoretical, methodological, and clinical concerns.

INTRODUCTION

Adolescent suicide is a complex phenomenon that has similarities and differences with adult suicidal behavior. Serotonergic (5-HT) dysfunction has extensively been studied in adults and has been postulated as a biological marker for suicide.

METHODS

We conducted a comprehensive review of the studies available in MEDLINE from January 1998 until January 2014 on the role of "serotonin" both in adults' and adolescents' "completed suicide", "suicide attempts", and "suicidal ideation".

RESULTS

Studies on 5-HT conducted in adults and replicated in adolescents have yielded inconsistent results. Although some genes related to the serotonergic system have been associated with an increased risk of suicide, attempts to reproduce those findings have been unsuccessful and a common genetic variant associated to suicidal behavior has yet to be identified.

DISCUSSION: Studies on the neurobiology of adolescent suicide should consider the biological specificities of this life stage and of gender differences during this period. Future research designs should also try to integrate findings in the psychological and biological domains. Prospective studies may help understand the process that leads from suicidal ideation to suicide attempts or completed suicides in this population.