Virginia Institute for Psychiatric and Behavioral Genetics and Department of Psychiatry, Virginia Commonwealth University, Richmond (Kendler, Edwards); Center for Primary Health Care Research, Lund University, Malmö, Sweden (Ohlsson, J. Sundquist, K. Sundquist); and Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York (J. Sundquist, K. Sundquist).
Am J Psychiatry. 2020 Oct 1;177(10):928-935. doi: 10.1176/appi.ajp.2020.20010017. Epub 2020 Aug 28.
The authors aimed to clarify the sources of parent-child transmission for suicide attempt and death by suicide.
Three sources of parent-child resemblance (genes plus rearing, genes only, and rearing only) were examined in parents and offspring from four family types from Swedish national samples: intact nuclear families, families with a not-lived-with biological father, families with a stepfather, and adoptees and their biological and adoptive parents. Parent-child resemblance was assessed primarily by tetrachoric correlation.
For suicide attempt to suicide attempt transmission, best-estimate tetrachoric correlations for genes plus rearing, genes only, and rearing only were 0.23 (95% CI=0.23, 0.24), 0.13 (95% CI=0.11, 0.15), and 0.14 (95% CI=0.11, 0.16), respectively. Suicide attempt was more strongly transmitted to male offspring compared with female offspring. Parental psychiatric disorders accounted for 40% of the genetic transmission but had no impact on rearing effects. For suicide death to suicide death transmission, best estimates of tetrachoric correlations for genes plus rearing, genes only, and rearing only were 0.16 (95% CI=0.15, 0.18), 0.07 (95% CI=0.02, 0.12), and -0.05 (95% CI=-0.17, 0.07), respectively. Although the suicide attempt-suicide death genetic correlation was high (0.84), the hypothesis that they reflect behaviors only differing in severity on the same continuum of genetic liability could be rejected.
The transmission of suicide attempt across generations is moderately strong and arises equally from genetic and rearing effects. Parental psychiatric illness explains almost half of the genetic transmission of suicide attempt but none of the rearing effect. Suicide death is modestly transmitted across generations, probably via genetic effects, although rearing may play a role. While suicide attempt and suicide death share a substantial proportion of their hereditary risk, they do not, from a genetic perspective, simply reflect milder and more severe forms of the same diathesis.
作者旨在阐明自杀未遂和自杀死亡的亲子传播来源。
在来自瑞典全国样本的四种家庭类型的父母和子女中,作者检查了亲子相似性的三个来源(基因加养育、仅基因和仅养育):完整的核心家庭、与未共同生活的亲生父亲的家庭、继父家庭以及被领养者及其亲生和养父母。亲子相似性主要通过四分相关评估。
对于自杀未遂到自杀死亡的传播,基因加养育、仅基因和仅养育的最佳估计四分相关系数分别为 0.23(95%置信区间=0.23,0.24)、0.13(95%置信区间=0.11,0.15)和 0.14(95%置信区间=0.11,0.16)。自杀未遂更多地传递给男性后代,而不是女性后代。父母的精神障碍占遗传传递的 40%,但对养育影响没有影响。对于自杀死亡到自杀死亡的传播,基因加养育、仅基因和仅养育的最佳估计四分相关系数分别为 0.16(95%置信区间=0.15,0.18)、0.07(95%置信区间=0.02,0.12)和-0.05(95%置信区间=-0.17,0.07)。尽管自杀未遂-自杀死亡的遗传相关性很高(0.84),但不能拒绝它们反映的是在同一遗传易感性连续体上仅严重程度不同的行为的假设。
自杀未遂在代际间的传递是中等强度的,同样来自遗传和养育的影响。父母的精神疾病解释了自杀未遂遗传传递的近一半,但没有解释养育的影响。自杀死亡在代际间适度传递,可能是通过遗传效应,但养育可能发挥作用。尽管自杀未遂和自杀死亡共享其遗传风险的很大一部分,但从遗传角度来看,它们并不是同一素质的更温和和更严重形式的反映。