Stress and Suicide: Are We Well-Equipped to Study this Issue?

Stress almost always precedes suicidality. Stress also is a harbinger of a variety of psychiatric disorders, most notably depression. Depression is a major precursor of suicidal behavior. Consequently, the question of whether stress is an epiphenomenon or a decisive factor in the causation of suicidality and (certain forms of) mood disorders is crucial. Certainty about this question can only be obtained when it can be demonstrated that stress phenomena may induce changes in brain functioning similar to the ones supposedly associated with suicidality and with (certain forms of) depression. Since the phenomenology of stress syndromes, as well as their emotional intensity, are highly variable, careful definition of the stress syndrome to be studied is a first requirement. In studies into the significance of stress in the occurrence of suicidality and depression, this degree of finesse has not been achieved. The major shortcomings have been discussed. These should be systematically addressed to provide research into the relation between stress and psychopathology with the necessary acuity.