[Suicide seen through neuroscience and cerebral imaging].

Abstract

Suicide remains a major public health problem today. It is most often linked to an underlying psychiatric pathology, with major depression at the top of the list. But while the majority of suicided patients are depressed, the majority of depressed patients do not commit suicide. It is therefore necessary to identify this subgroup of depressed patients at risk for suicide. It presents a particularly risky diathesis for suicidal behaviour. Cognitive neurosciences help us to clarify this diathesis and identify these depressed patients at risk for suicide. This sometimes concerns emotional dysregulation and the misinterpretation of social signals emitted by others, sometimes the presence of aggressive or impulsive traits in decision-making and problem solving. Treating depression aggressively, including resistant depression, is therefore very important. Contrary to what had been advanced a few decades ago, the prescription of antidepressants does not increase the risk of suicide in the month following their introduction, and it is also the case in children and adolescents. New therapeutic options for resistant depression, such as esketamine or repetitive transcranial magnetic stimulation, are welcome.