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Book Forum: Suicide   |    
The Neurobiology of Suicide: From the Bench to the Clinic: Annals of the New York Academy of Sciences, vol. 836
MICHAEL GARVEY, M.D.
Am J Psychiatry 1999;156:654-654.
View Author and Article Information
Iowa City, Iowa

edited by David M. Stoff, J. John Mann. New York, New York Academy of Sciences, 1997, 363 pp., $80.00 (paper).

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Suicide causes more than 30,000 deaths annually in the United States. Significant progress at preventing suicide will come from a better understanding of the biological underpinnings of suicide and the interaction of this biology with environmental stressors. The Neurobiology of Suicide: From the Bench to the Clinic provides an excellent review of the biology of suicide.

Many experts have contributed chapters to this text. It is well written, detailed, and comprehensive. The book is divided into four sections: Preclinical Studies, Clinical Neurobiology, Treatment, and Summary. Topics include genetics of suicide, involvement of neurotransmitters and receptors in suicide, the role stress and the brain-pituitary-adrenal axis might play in suicidal behavior, postmortem studies of suicide victims, the neuropathology of suicide, and studies of animal behavior that may offer insight into human suicide. Several authors discuss strategies for future suicide research. Important corollary issues, such as definitions of suicide, are covered.

The chapters that deal with treatment of suicidal patients are intriguing. There are numerous books, articles, and professional workshops about suicide prevention. Despite these volumes of advice, there is little carefully designed empirical research about whether interventions aimed at preventing suicidal behaviors are effective. Did you know that many studies of treatment of suicide exclude patients considered at high risk for suicide? There is some information to suggest what might work. Certain kinds of psychosocial intervention may be of benefit. A review of the literature suggests that treatment with lithium may lower the risk of suicide. What about traditional antidepressants or behavior therapy? Is there any good evidence that hospitalization of potentially suicidal patients lowers the rate of suicide? I cannot reveal the whole plot, but if these topics interest you, this text offers an outstanding review of the treatment of suicidal patients.

Individual chapters present detailed, comprehensive, and well-referenced information. The authors present complicated issues in a clear and thorough manner. Although this book may not be considered pleasure reading for the beach, it deserves the attention of any serious student of suicide. In summary, this text deserves a "two thumbs up" rating.

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