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与韩国心境障碍患者自杀行为相关的心理和遗传风险因素。

Psychological and genetic risk factors associated with suicidal behavior in Korean patients with mood disorders.

机构信息

Department of Psychiatry, Ewha Womans University College of medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea.

Department of Psychiatry, Ewha Womans University College of medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea; Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.

出版信息

J Affect Disord. 2018 Aug 1;235:489-498. doi: 10.1016/j.jad.2018.04.059. Epub 2018 Apr 10.

Abstract

INTRODUCTION

To prevent suicide, a nationwide important issue in Korea, understanding its etiology is essential. This study aimed to delineate the risk factors for suicidal behavior in mood disorder patients in Korea.

METHODS

216 patients with mood disorders were recruited. We measured suicidal ideation (SI) and suicide attempt (SA) history and the association of six gene polymorphisms with SB: COMT (rs4680), HTR1A (rs6295), TPH1 (rs1800532), BDNF (rs6265), SLC1A3 (rs2269272), and SLC1A2 (rs4755404).

RESULTS

Patients in the high-SI and SA groups reported more severe depressive, hopelessness, and anxiety symptoms and lower resilience and used less social support-seeking coping than those in the non-significant SI and non-SA groups. Multivariate logistic analysis revealed that depressive disorder, depressive symptoms, poor social support, and less social support-seeking coping were significant independent predictors of suicidal ideation. After adjustment for covariates, age, alcohol consumption, and the rs4680 AA genotype in the COMT gene were associated with suicide attempt.

LIMITATIONS

The modest sample size and a relatively few candidate genes are limitations of the study. In addition, there is no normal control group and the retrospective evaluation of SA limits the interpretation of the causal relationship with factors affecting SA.

CONCLUSIONS

Suicidal behavior in Korean patients with mood disorders may be associated with younger age, alcohol consumption, depressive symptoms, poor social support, less social support-seeking coping, and the COMT rs4680 Met/Met genotype.

摘要

简介

为了预防自杀这一韩国全国范围内的重要问题,了解其病因至关重要。本研究旨在描绘韩国心境障碍患者自杀行为的风险因素。

方法

招募了 216 名心境障碍患者。我们测量了自杀意念(SI)和自杀尝试(SA)的历史,以及六个基因多态性与 SB 的关联:COMT(rs4680)、HTR1A(rs6295)、TPH1(rs1800532)、BDNF(rs6265)、SLC1A3(rs2269272)和 SLC1A2(rs4755404)。

结果

高 SI 和 SA 组的患者报告了更严重的抑郁、绝望和焦虑症状,以及更低的适应力和更少的社会支持寻求应对方式,而非显著 SI 和非 SA 组的患者则报告了较少的抑郁、绝望和焦虑症状,以及更高的适应力和更多的社会支持寻求应对方式。多变量逻辑分析显示,抑郁障碍、抑郁症状、不良的社会支持和较少的社会支持寻求应对方式是自杀意念的显著独立预测因素。在调整了协变量后,年龄、饮酒和 COMT 基因中的 rs4680 AA 基因型与自杀尝试相关。

局限性

研究的局限性在于样本量适中,候选基因相对较少。此外,没有正常对照组,SA 的回顾性评估限制了对影响 SA 的因素的因果关系的解释。

结论

韩国心境障碍患者的自杀行为可能与年龄较小、饮酒、抑郁症状、不良的社会支持、较少的社会支持寻求应对方式和 COMT rs4680 Met/Met 基因型有关。

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