Department of Psychiatry, University College Hospital, Ibadan, Nigeria.
Mol Psychiatry. 2011 Dec;16(12):1221-33. doi: 10.1038/mp.2010.111. Epub 2010 Nov 16.
Previous research suggests that parental psychopathology predicts suicidal behavior among offspring; however, the more fine-grained associations between specific parental disorders and distinct stages of the pathway to suicide are not well understood. We set out to test the hypothesis that parental disorders associated with negative mood would predict offspring suicide ideation, whereas disorders characterized by impulsive aggression (for example, antisocial personality) and anxiety/agitation (for example, panic disorder) would predict which offspring act on their suicide ideation and make a suicide attempt. Data were collected during face-to-face interviews conducted on nationally representative samples (N=55 299; age 18+) from 21 countries around the world. We tested the associations between a range of parental disorders and the onset and persistence over time (that is, time since most recent episode controlling for age of onset and time since onset) of subsequent suicidal behavior (suicide ideation, plans and attempts) among offspring. Analyses tested bivariate and multivariate associations between each parental disorder and distinct forms of suicidal behavior. Results revealed that each parental disorder examined increased the risk of suicide ideation among offspring, parental generalized anxiety and depression emerged as the only predictors of the onset and persistence (respectively) of suicide plans among offspring with ideation, whereas parental antisocial personality and anxiety disorders emerged as the only predictors of the onset and persistence of suicide attempts among ideators. A dose-response relation between parental disorders and respondent risk of suicide ideation and attempt was also found. Parental death by suicide was a particularly strong predictor of persistence of suicide attempts among offspring. These associations remained significant after controlling for comorbidity of parental disorders and for the presence of mental disorders among offspring. These findings should inform future explorations of the mechanisms of intergenerational transmission of suicidal behavior.
先前的研究表明，父母的精神病理学预示着子女的自杀行为；然而，特定父母障碍与自杀途径各个阶段之间更精细的关联尚不清楚。我们着手检验这样一个假设，即与负面情绪相关的父母障碍会预测子女的自杀意念，而以冲动攻击为特征的障碍（例如反社会人格）和焦虑/烦躁（例如惊恐障碍）会预测哪些子女会将自杀意念付诸行动并尝试自杀。数据是在全球 21 个国家进行的全国代表性样本（年龄 18 岁及以上；N=55299）的面对面访谈中收集的。我们测试了一系列父母障碍与子女随后自杀行为（自杀意念、计划和尝试）的发病和随时间持续（即，最近一次发作后控制发病年龄和发病时间）之间的关联。分析测试了每种父母障碍与不同形式自杀行为之间的双变量和多变量关联。结果表明，所检查的每种父母障碍都会增加子女自杀意念的风险，父母广泛性焦虑症和抑郁症是子女有自杀意念时出现自杀计划发病和持续（分别）的唯一预测因素，而父母反社会人格和焦虑障碍则是子女有自杀意念时自杀尝试发病和持续的唯一预测因素。还发现了父母障碍与受访者自杀意念和尝试风险之间的剂量-反应关系。父母自杀死亡是子女自杀尝试持续存在的一个特别强烈的预测因素。在控制父母障碍的共病和子女中精神障碍的存在后，这些关联仍然显著。这些发现应该为未来探索自杀行为代际传递的机制提供信息。
