Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
J Am Acad Child Adolesc Psychiatry. 2010 Feb;49(2):114-21. doi: 10.1097/00004583-201002000-00005.
Exposure to suicidal behavior in peers and relatives is thought to increase risk for suicidal behavior in vulnerable individuals, possibly as a result of imitation or modeling. This study examines exposure to suicidal behavior and likelihood of suicide attempt in a high-risk cohort of offspring of a depressed parent.
A total of 449 offspring of 255 probands with a mood disorder were enrolled in a family study. Probands and offspring were assessed for psychopathology and suicide attempt history, and offspring for suicide exposure. Generalized estimating equations (GEE) and generalized least squares models were used to compare suicide attempt history in exposed and nonexposed offspring as well as characteristics of exposure in exposed offspring suicide attempters and exposed nonattempters. GEE was used to compare exposure occurring before first attempt in attempter offspring and exposure occurring before the same age in matched nonattempter offspring.
Offspring reporting exposure to suicidal behavior were four times more likely to report a lifetime suicide attempt compared with unexposed offspring, controlling for age. Suicide attempt status was not associated with age at first exposure, total number or degree (attempt or threat) of exposures, or relationship. Analysis of exposure occurring before age at first suicide attempt found no association between exposure and suicide attempt.
Offspring exposed to suicidal behavior are more likely to report a lifetime suicide attempt than nonexposed offspring. However, when examining the temporal sequence of exposure and attempt, the association is no longer significant, suggesting that imitation is not sufficient explanation.
同辈和亲属的自杀行为暴露被认为会增加易受影响个体自杀行为的风险，这可能是模仿或模仿的结果。本研究检查了在患有抑郁症父母的高危子女队列中，自杀行为暴露与自杀企图的可能性。
共有 255 名心境障碍患者的 449 名子女参加了一项家庭研究。对先证者和子女进行了精神病理学和自杀企图史评估，对子女进行了自杀暴露评估。使用广义估计方程（GEE）和广义最小二乘法模型比较了暴露和未暴露子女的自杀企图史，以及暴露子女自杀企图者和暴露非企图者的暴露特征。GEE 用于比较在企图子女中首次尝试之前发生的暴露与在匹配的非企图子女中相同年龄之前发生的暴露。
与未暴露的子女相比，报告自杀行为暴露的子女报告一生中自杀企图的可能性高 4 倍，控制了年龄。自杀企图状态与首次暴露年龄、暴露次数或程度（企图或威胁）、或关系无关。对首次自杀企图之前发生的暴露的分析发现，暴露与自杀企图之间没有关联。
暴露于自杀行为的子女比未暴露的子女更有可能报告一生中的自杀企图。然而，当检查暴露和企图的时间顺序时，这种关联不再显著，这表明模仿不是充分的解释。
