Abstract
Suicide represents a priority clinical challenge because of the lack of specific biological and molecular biomarkers. The development of such markers would, together with clinical findings, allow for a concrete diagnosis. MicroRNAs (miRNAs), because of their stability in biological fluids and their role in gene regulation, emerge as useful candidates to complement traditional clinical evaluation. This narrative review synthesizes evidence on the role of miRNAs as biomarkers in suicide and suicidal behavior, based on reports in brain tissue and fluids such as peripheral blood, integrating data on miRNA regulation and their associated molecular pathways. Several miRNAs, including miR-124, miR-18a, miR-132, miR-185, miR-218, and miR-19a-3p, are consistently dysregulated across multiple studies. These findings suggest that miRNA measurement could complement clinical scales and provide an objective biological marker for suicide risk. Their integration into diagnostic protocols could improve risk stratification and open the door to personalized prevention strategies; however, it is essential to validate miRNA panels in multicenter clinical studies before routine implementation.