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Pursuing the elusive biosignature for suicide: a decennial update
Ran Barzilay1,2,3, Katherin Sudol4, Nikolaos P Daskalakis5,6,7
1Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Molecular Psychiatry
|March 13, 2026
Summary
Suicide is a leading cause of death for young people. Research shows biological differences in stress response and serotonin systems in those who died by suicide.
Area of Science:
- Neuroscience and Psychiatry
- Genomics and Molecular Biology
- Environmental Health
Background:
- Suicide is a significant public health issue, particularly among adolescents and young adults.
- Suicide risk is influenced by a complex interplay of genetic, environmental, and stress-related factors.
- Previous research has yielded ambiguous findings regarding biological correlates of suicide due to confounding factors.
Purpose of the Study:
- To review and synthesize findings from the past decade on biological measures in suicide decedents compared to controls.
- To identify stress-related biological pathways, inflammation, neuroplasticity, and the serotonergic system as potential contributors to suicide.
- To address ambiguity in prior studies by focusing on biological differences specific to suicide, independent of psychiatric comorbidity.
Main Methods:
- Systematic review of postmortem studies comparing biological measures between suicide decedents and control decedents over the last 10 years.
- Inclusion criteria prioritized studies ensuring biological differences were specific to suicide and not due to confounding psychiatric conditions.
- Analysis of research employing data-driven approaches, including genomic, transcriptomic, and methylomic analyses.
Main Results:
- Evidence suggests alterations in stress-related biological systems in suicide decedents.
- A decrease in serotonergic tone was observed among suicide decedents.
- While multi-omic studies show potential, current findings lack interpretability.
Conclusions:
- Biological alterations in stress pathways and serotonergic systems are implicated in suicide.
- Future research requires larger sample sizes, diverse brain regions, and specific cell types for robust multi-omic studies.
- Integrating poly-environmental stress exposure (exposomic) models may clarify the link between environmental stress and biological mechanisms in suicide.
