Debate aspects of suicidology: the relationship of neuroinflammatory with suicidal behavior in persons with mental disorders. Part II

The pathophysiology of the formation of suicidal behavior is considered using examples of the connection between neuroinflammation and its manifestations (suicidal thoughts, suicidal attempts and completed suicides) in individuals with such mental disorders as: depressive disorder (major, peripartum depression), neurogenic anorexia (anorexia nervosa), schizophrenia, as well as suicides (suicidal behavior) associated with infectious diseases (T. gondii, COVID-19). As a result of the analysis of a large body of literature data, a particular hypothesis is expressed that mentally ill people with suicidal behavior (who have committed suicide) differ from mentally ill people without suicidal behavior in the presence of genetic and/or metabolic markers of chronic low-grade neuroinflammation in the former. Signs of neuroinflammation are also observed in patients who have recovered from COVID-19, at least in the early post-Covid period (up to 100 days after recovery) and in individuals who are carriers of T. gondii. These data are compared with a previously identified increase in the number of suicides in the group of people who had respiratory infections and people with allergies to pollen. Analysis of the mechanisms of triggering neuroinflammation associated with suicidal behavior (completed suicides) in some mental disorders allows us to conclude that there is no direct connection between suicides in mental patients and their underlying disease and the need to consider suicidal behavior (completed suicides) in mental patients as comorbid condition. Suicide patients without previous clinical mental disorders and with different clinically diagnosable mental disorders can be divided into a separate homogeneous group - patients with suicidal behavior. They are united by suicidal activity, which is induced by the causes of neuroinflammation described above, which proves the biological multifactorial nature of suicidality.