Neurológia pre prax 2/2009

Neuropsychobiológia suicídia

prof. MUDr. Peter Kukumberg, PhD.

Suicídium je fatálnym aktom ultraextrémneho úsudku, rozhodnutia a konania. Javí sa ako deštrukčný antipól pudu sebazáchovy alebo desivá sebapoprava jedinca v roli sudcu, obhajcu a kata. Kauzálne a empiricky býva najčastejšie u depresívnej poruchy, schizofrénie, dekompenzovaných abúzov, stavov po miešnej traume, sclerosis multiplex, Parkinsonovej a Huntingtonovej chorobe, epilepsii. Nevyskytuje sa v animálnej ríši. Niet systémovej prevencie. Početné, ale nekonkluzívne nálezy (zväčša post mortem) usvedčujú zo spoluúčasti na suicidiálnom chovaní a konaní neurotrasmitery (serotonín, dopamin, GABA a i.), resp. ďalšie substancie v krvi, likvore, tkanive a moči. Niet evidentného dôkazu genetickej deviácie. Nepoznáme suicidiálne markery. Suicídium predstavuje mimoriadne závažný sociologicko- medicínsky problém s vágnou prevenciou, ktorý sa radí celosvetovo k 5 najčastejším príčinam smrti.

Kľúčové slová: suicídium, definície suicídia, prevencia suicídia, sociologicko-medicínsky fenomén suicídia, neurotransmitery, depresívna porucha, Parkinsonova choroba, Huntingtonova choroba, sclerosis multiplex, epilepsia

Neuropsychobiology of suicide

Suicide is a fatal act of ultra-extreme judgement, determination, and conduct. It appears as a destructive antipole of the instinct of self-preservation or as a terrifying self-execution of an individual being one‘s own judge, advocate, and executioner. In causal and empirical terms, it most commonly occurs with a depressive disorder, schizophrenia, decompensated abuse, conditions following spinal cord trauma, multiple sclerosis, Parkinson‘s disease, Huntington‘s disease, and epilepsy. It does not occur among animals. There is no systemic prevention. Numerous but inconclusive findings (mostly post mortem) indicate that neurotransmitters (serotonin, dopamine, GABA, etc.) and/or other substances in the blood, cerebrospinal fluid, tissue, and urine are involved in suicidal behaviour and action. There is no clear evidence of a genetic deviation. No suicidal markers have been established. Suicide represents an extremely serious sociological-medical problem with poor prevention and is among the five leading causes of death.

Keywords: suicide, suicide definitions, suicide prevention, sociological-medical phenomenon of suicide, neurotransmitters, depressive disorder, Parkinson‘s disease, Huntington‘s disease, multiple sclerosis, epilepsy