Sazonalidade do comportamento suicida: evidências do papel da luz como um possível modulador

Abstract

Suicide is a serious public health problem around the world. Each year, approximately 800.000 people complete suicide and it is estimated that for each suicide committed, there must be another 20 attempts. Differences have been reported between individuals who attempted suicide and those who committed suicide. These tend to be male, older, less impulsive, using more lethal methods, leave suicidal note and are more depressed. The attempters tend to be female and use a non-violent method, such as poisoning. Despite these differences, a seasonal pattern has been described with peak in the spring / summer, but there are divergences in suicide attempts. This lack of consensus allowed us to evaluate through a systematic review if these attempts occur more frequently in the spring / summer as already described for cases of suicide. A seasonal profile similar to the occurrences of suicide was also found for suicide attempts. This seasonal behavior suggests the influence of an environmental modulator, and since light is the main synchronizing agent of the endogenous rhythm with the environment through the light-dark cycle, it is also likely to be an important agent of the circannual / seasonal rhythms. As Brazil is a country with great territorial extension, crossing the Equator line (latitude 0º) and the Tropic of Capricorn (latitude S24°14’), we investigated the influence of latitude and photoperiod in the seasonality of suicides in all Brazilian cities in the period from 2010 to 2015. A seasonal variation of suicides were find with peak in late spring / early summer and nadir in winter. This seasonal profile is better observed as latitude decreases. The further away from latitude 0 °, the higher the suicide rate and amplitude (Peak / Trough ratio), and the in-phase correlation between the seasonality of suicide occurrences and the photoperiod. As several diseases have been associated with disturbances in circadian rhythm, this environmental modulation of the circadian rhythm may play a relevant role in the formation of seasonal suicidal behavior in individuals with vulnerability. In animals, the manipulation of the photoperiod, simulating seasons, results in changes in the gene expression and behavioral profile. We studied, in C57BL / 6J mice, the effect of the photoperiod gradual variation, a simulation from winter to summer, to observe the molecular effect in brain structures related to human suicide and behavioral changes. A significant decrease in circadian gene expression and loss of rhythmicity were found, in addition to an antidepressant-like behavior in the forced swimming test. The photoperiodic influence observed in animal models associated with seasonal suicide reports only in countries distant from 0º latitude, where there are significant alterations in the photoperiod, reinforce the participation of light as an important modulator of the seasonality of suicidal behavior.