Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, School of Medicine, University of Pisa, Pisa, Italy.
Neuropsychobiology. 2013;68(4):250-7. doi: 10.1159/000356228. Epub 2013 Nov 21.
Literature findings mainly support the notion that suicide attempts (SA) and self-mutilating behavior (SMB) are distinct behaviors, although they may share common psychopathological features. In the present paper we aimed to identify behavioral phenotypes in patients with SA, SMB, or both (SAM) and to analyze the association with candidate genes.
One hundred forty-two inpatients with a history of SA (n = 86), SMB (n = 22), and SAM (n = 39) were included in this study. Subjects were evaluated using the Tridimensional Personality Questionnaire (TPQ) and the Buss-Durkee Hostility Inventory (BDHI). Polymorphisms within serotonin transporter (SLC6A4, HTTLPR), catechol-O-methyl transferase (COMT, Val158Met), and tryptophan hydroxylase (TPH, 218C>A) were also analyzed.
Principal component factor analysis including the BDHI and TPQ produced 3 factors that could classify the 3 groups of patients with good sensitivity. However, only the 'pure suicidal' factor had a sufficient positive predictive value. This factor was characterized by high levels of persistence (PS) and, to a lower extent, reward dependence. The distribution of genotypes was not different across patient groups for all polymorphisms, but the SS genotype of HTTLPR was significantly associated with the 'self-mutilation' factor, characterized by high levels of hostile traits, novelty seeking, and harm avoidance.
The results of the present study suggest that different and overlapping temperamental traits in suicidal and self-mutilating patients are present, although only high levels of PS could predict SA repetition. Finally, HTTLPR may mediate the risk for SMB through modulation of some temperamental traits.
文献研究结果主要支持自杀未遂（SA）和自伤行为（SMB）是两种不同行为的观点，尽管它们可能具有共同的精神病理学特征。在本研究中，我们旨在确定有 SA、SMB 或两者（SAM）病史的患者的行为表型，并分析其与候选基因的关联。
本研究纳入了 142 名有 SA（n = 86）、SMB（n = 22）和 SAM（n = 39）病史的住院患者。采用三维人格问卷（TPQ）和布斯-达德利敌意量表（BDHI）对受试者进行评估。还分析了 5-羟色胺转运体（SLC6A4，HTTLPR）、儿茶酚-O-甲基转移酶（COMT，Val158Met）和色氨酸羟化酶（TPH，218C>A）的多态性。
包括 BDHI 和 TPQ 的主成分因子分析产生了 3 个因子，可对 3 组患者进行分类，具有良好的敏感性。然而，只有“纯粹的自杀”因子具有足够的阳性预测值。该因子的特点是高水平的坚持性（PS），在较低程度上，还具有奖励依赖。所有多态性在患者组之间的基因型分布没有差异，但 HTTLPR 的 SS 基因型与“自伤”因子显著相关，该因子的特点是具有高水平的敌对特质、寻求新奇和回避伤害。
本研究结果表明，自杀和自伤患者存在不同但重叠的气质特征，尽管只有高水平的 PS 才能预测 SA 复发。最后，HTTLPR 可能通过调节某些气质特征来介导 SMB 的风险。
