The prospect of suicide biomarkers: from neurobiology to precision prevention

Suicide remains a global public health crisis, accounting for over 720,000 deaths annually. Despite progress in identifying risk factors and developing theoretical frameworks, suicide continues to be a complex biopsychosocial phenomenon that eludes comprehensive understanding. This review synthesizes current evidence on the neurobiological underpinnings of suicidal behavior, encompassing genetic and epigenetic vulnerabilities, systemic physiological dysregulations, and structural and functional brain alterations. Furthermore, it critically evaluates recent advances in biologically-targeted interventions and assesses the translational potential of biomarker research for precision psychiatry. While these developments provide promising avenues for objective risk stratification and targeted treatments, significant challenges persist in bridging the gap between scientific discovery and clinical implementation. By integrating evidence across these disciplines, this review aims to provide clinicians and researchers with a comprehensive reference to inform clinical practice and guide future research directions.