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美国部署到伊拉克和阿富汗的现役军人当前自杀意念的遗传预测因子。

Genetic predictor of current suicidal ideation in US service members deployed to Iraq and Afghanistan.

机构信息

Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, USA.

Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, USA.

出版信息

J Psychiatr Res. 2019 Jun;113:65-71. doi: 10.1016/j.jpsychires.2019.03.007. Epub 2019 Mar 17.

Abstract

OBJECTIVE

Suicide is one of the ten leading causes of death in United States and the suicide rate in the military population has increased since the start of the Iraq and Afghanistan wars. However, few biomarkers for current suicidal ideation (CSI) have been identified. The current study examined the association of four candidate genes with CSI in active duty US Army Special Operations Command and National Guard units (n = 3,889) who served in Iraq and Afghanistan between November 2009 and July 2014.

METHODS

Current PTSD symptoms and CSI were assessed using the PTSD Checklist (PCL) and PHQ-9, respectively. Traumatic events were assessed using items from the Life Events Checklist (LEC) that met the DSM-IV PTSD criteria of a traumatic stressor. All genotypes of saliva DNA were discriminated using the TaqMan 5'-exonuclease assay.

RESULTS

The associations between CSI and brain-derived neurotrophic factor (BDNF), FK506 binding protein (FKBP5), catechol-O-methyltransferase (COMT), or S100A10 (p11) were examined. We found CSI was associated with BDNF (OR = 1.5, 95% CI = 1.5-1.8, P = 0.0002), but not FKBP5, COMT and p11. Female soldiers reported CSI more often than males (χ2 = 7.403, p = 0.0065), although gender did not affect CSI severity. In addition, associations were found between CSI and depression, PTSD, and BDNF, but not traumatic events. The BDNF Val66Met contributed to the severity of CSI even after adjusting to PTSD, depression and LEC.

CONCLUSIONS

The associations of BDNF with CSI and its severity suggest that BDNF may be a predictor of suicidal risk and present an opportunity to develop laboratory tools with clinical implications in suicide prevention and treatment.

摘要

目的

自杀是美国十大主要死因之一,自伊拉克和阿富汗战争开始以来,军队人口的自杀率有所上升。然而,目前很少有针对当前自杀意念(CSI)的生物标志物被确定。本研究检查了四个候选基因与 2009 年 11 月至 2014 年 7 月期间在伊拉克和阿富汗服役的现役美国特种作战司令部和国民警卫队部队(n=3889)中当前 PTSD 症状和 CSI 的关联。

方法

使用 PTSD 检查表(PCL)和 PHQ-9 分别评估当前 PTSD 症状和 CSI。使用符合 DSM-IV PTSD 创伤性应激源标准的生活事件检查表(LEC)中的项目评估创伤事件。使用 TaqMan 5'-exonuclease 测定法区分所有唾液 DNA 基因型。

结果

研究了 CSI 与脑源性神经营养因子(BDNF)、FK506 结合蛋白(FKBP5)、儿茶酚-O-甲基转移酶(COMT)或 S100A10(p11)之间的关联。我们发现 CSI 与 BDNF 相关(OR=1.5,95%CI=1.5-1.8,P=0.0002),但与 FKBP5、COMT 和 p11 无关。女兵报告的 CSI 比男兵多(χ2=7.403,p=0.0065),尽管性别并未影响 CSI 的严重程度。此外,还发现 CSI 与抑郁、PTSD 和 BDNF 之间存在关联,但与创伤事件无关。BDNF Val66Met 即使在调整 PTSD、抑郁和 LEC 后,也与 CSI 的严重程度有关。

结论

BDNF 与 CSI 及其严重程度的关联表明 BDNF 可能是自杀风险的预测指标,并为开发具有临床意义的自杀预防和治疗实验室工具提供了机会。

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