Suicide as a multifactorial pathology

Such a fundamental concept as suicidal behavior (SB) does not have clearly defined boundaries and content. Currently, SB and suicide are considered as a multifactorial pathology. However, classical studies based on the criteria of F. Vogel and A. Motulski confirming this idea have not yet been carried out. The aim of the study was to demonstrate the multifactorial nature of suicide (SB) and to identify observable predictor criteria that make it possible to confidently diagnose the presence of SB in a subject and assess the risk of suicide. Results. Using median data on the number of suicides per 100,000 people committed by the US population from 2000-2019 in 5-year age cohorts, we showed that suicide rates increase sharply before age 14, peak at ages 45–54, and rise again sharply at ages 65 and older. In the periods 0-14, 20-24, 23-25 and 45-54 years of age, the annual number of suicides varies greatly, which is reflected in the coefficients of variation of the suicide rate in these intervals by year (28.2, 17.5, 23.6, 14.9, respectively). In other age intervals, the coefficients of variation are less than or close to 10%. When the twin criterion was calculated from publicly available data, its value ranged from 6.4 to 18.6 depending on the data provided by the authors, with a cutoff value of 4.0. The segregation coefficient value was 2.7 with a threshold value of 2.0. The obtained graphical and calculated results allow us to objectively conclude that SB and suicide are indeed multifactorial pathologies. Based on previously conducted and published analytical studies of freely available literature on SB and the evidence of its multifactorial nature obtained in this work, we have developed and proposed a multifactorial hypothesis of SB and its completion by suicide, covering almost the entire known range of genetic and pathophysiological phenomena associated with SB. Based on these ideas, a scale of observable (objective) predictors of SB was proposed for discussion by suicidologists. It was concluded that SB and suicide correspond to a set of class indicators of multifactorial pathology. Keywords: definition of suicidal behavior, criteria, suicide, twin criterion, segregation criterion, multifactorial hypothesis