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Previous studies have shown that suicidal states are associated with various biochemical changes affecting neurotransmitter systems (i.e., serotonin, glutamate, -aminobutyric acid, and their signaling pathways) [8,9,10,11], the inflammatory response [12], hypothalamicpituitaryadrenal axis [13], and glial cell function/neurotrophic factors [14, 15]

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Setting realistic expectations as well as recognizing that multiple sessions are often required to see gradual improvement is very important

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