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童年逆境、FKBP5、BDNF、NRN1 和一般自我效能感在酒精依赖患者自杀未遂中的作用。

The role of childhood adversities, FKBP5, BDNF, NRN1, and generalized self-efficacy in suicide attempts in alcohol-dependent patients.

机构信息

Masovian Regional Psychiatric Hospital Drewnica, Ząbki, Poland.

Central Scientific Laboratory, Medical University of Lodz, Lodz, Poland.

出版信息

Pharmacol Rep. 2020 Jun;72(3):730-743. doi: 10.1007/s43440-020-00080-8. Epub 2020 Mar 10.

Abstract

BACKGROUND

Alcohol-dependent (AD) patients report higher number of adverse childhood experiences (ACEs), develop poor social skills, and have a higher rate of suicide attempts than the general population. We hypothesize that the association between ACEs and lifetime suicide attempts in AD patients is mediated by generalized self-efficacy and selected functional single nucleotide polymorphisms (SNPs) in genes involved in the stress response and neuroplasticity, including: FKBP5 rs1360780, BDNF rs6265, and NRN1 rs1475157.

METHODS

176 AD patients and 127 healthy controls self-reported ACEs with the ACE Study questionnaire and three additional questions that inquired about ACE categories of acute stress; generalized self-efficacy-with the Generalized Self-Efficacy Scale. Genotyping for the three analysed SNPs was performed according to the manufacturer's standard PCR protocol. Hypotheses were tested with bivariate analyses, multiple regression model, and mediation models.

RESULTS

Higher levels of generalized self-efficacy were associated with a blunted effect of ACEs on the risk of suicide attempts. The prevalence of the three analyzed SNPs genotypes and alleles did not differ between AD patients with a positive vs. negative lifetime history of suicide attempt and was not associated with GSES scoring.

CONCLUSIONS

Generalized self-efficacy should be considered as a target for psychotherapeutic interventions aimed at reducing the risk of suicide attempts in AD patients who were exposed to childhood victimization. The negative results concerning the hypothesized role of the three analysed SNPs should be carefully interpreted due to the relatively small study sample, but represent a theoretical foundation for further research studies with larger study samples.

摘要

背景

与普通人群相比,酒精依赖(AD)患者报告的童年期不良经历(ACEs)更多,社交技能较差,自杀尝试率更高。我们假设,AD 患者 ACEs 与终生自杀尝试之间的关联是由广义自我效能和参与应激反应和神经可塑性的基因中的选定功能单核苷酸多态性(SNP)介导的,包括:FKBP5 rs1360780、BDNF rs6265 和 NRN1 rs1475157。

方法

176 名 AD 患者和 127 名健康对照者通过 ACE 研究问卷和另外三个询问急性应激 ACE 类别的问题报告 ACEs;通过一般自我效能感量表报告广义自我效能感。根据制造商的标准 PCR 方案对三种分析 SNP 进行基因分型。通过双变量分析、多元回归模型和中介模型检验假设。

结果

更高水平的广义自我效能与 ACE 对自杀尝试风险的影响减弱有关。AD 患者阳性与阴性终生自杀尝试史之间三种分析 SNP 基因型和等位基因的患病率没有差异,与 GSES 评分无关。

结论

应将广义自我效能视为针对暴露于童年期创伤的 AD 患者的自杀尝试风险降低的心理治疗干预的目标。由于研究样本相对较小,因此应谨慎解释关于三种分析 SNP 假设作用的阴性结果,但代表了进一步具有更大研究样本的研究的理论基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64be/8217039/786b838b6723/43440_2020_80_Fig1_HTML.jpg

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