Résumé
Current knowledge suggests that suicidal behaviors: 1) are pathological entities per se, with a specific neurobiology, 2) may be studied according to a stress-diathesis model, 3) may be better characterized by identifying biomarkers. Interpersonal difficulties, causing psychological pain, are associated with impaired decision-making underpinned by prefrontal dysfunction that has been associated with suicidal vulnerability. This would engage the subject to promote a choice (suicide) associated with immediate reward (pain relief), despite deleterious consequences (death). Thus, psychological pain is central to suicidal behavior as an immediate consequence of psychosocial stressors, and influencing the suicidal vulnerability favoring pain perception and increasing susceptibility to social events, based on neuroanatomical and biochemical bases involving opioidergic and vasopressinergic systems, as well as inflammation. Finally the hypothesis that a change of pain perception is involved in the suicidal process would open new avenues for understanding suicidal pathophysiology. It allows considering the psychological pain as a potential therapeutic target to prevent suicide.