Harika-Germaneau Ghina, Lafay-Chebassier Claire, Langbour Nicolas, Thirioux Bérangère, Wassouf Issa, Noël Xavier, Jaafari Nemat, Chatard Armand
Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, France.
Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, Poitiers, France.
Front Psychiatry. 2022 Apr 1;13:770414. doi: 10.3389/fpsyt.2022.770414. eCollection 2022.
The severity of symptoms represents an important source of distress in patients with a psychiatric disease. However, the extent to which this endogenous stress factor interacts with genetic vulnerability factors for predicting suicide risks remains unclear.
We evaluated whether the severity of symptoms interacts with a genetic vulnerability factor (the serotonin transporter gene-linked promoter region variation) in predicting the frequency of lifetime suicide attempts in patients with a psychiatric disease. Symptom severity and 5-HTTLPR polymorphism were collected from a sample of 95 patients with obsessive-compulsive disorder (OCD). Lifetime suicide attempt was the primary outcome, and antecedent of multiple suicide attempts was the secondary outcome.
The gene-by-symptoms interaction was associated with an excess risk of suicide attempts (OR = 4.39, 95CI[1.44, 13.38], < 0.009) and of multiple suicide attempts (OR = 4.18, 95CI[1.04, 16.77], = 0.043). Symptom severity (moderate, severe, or extreme) was associated with an approximately five-fold increase in the odds of a lifetime suicide attempt in patients carrying one or two copies of the short allele of 5-HTTLPR. No such relationship was found for patients carrying the long allele.
This study provides preliminary evidence for the gene-by-stress interaction on suicide attempt when stress is operationalized as symptom severity. Progress in suicide research may come from efforts to investigate the gene-by-symptoms interaction hypothesis in a variety of diseases.
症状的严重程度是精神疾病患者痛苦的一个重要来源。然而，这种内源性应激因素与预测自杀风险的遗传易感性因素之间相互作用的程度仍不清楚。
我们评估了在预测精神疾病患者终生自杀未遂频率时，症状严重程度是否与一种遗传易感性因素（血清素转运体基因连锁启动子区域变异）相互作用。从95例强迫症（OCD）患者样本中收集症状严重程度和5-HTTLPR多态性。终生自杀未遂是主要结局，多次自杀未遂的既往史是次要结局。
基因与症状的相互作用与自杀未遂（比值比[OR]=4.39，95%置信区间[CI][1.44,13.38]，P<0.009）和多次自杀未遂（OR=4.18，95%CI[1.04,16.77]，P=0.043）的额外风险相关。症状严重程度（中度、重度或极重度）与携带5-HTTLPR短等位基因一个或两个拷贝的患者终生自杀未遂几率增加约五倍相关。携带长等位基因的患者未发现这种关系。
本研究为当应激以症状严重程度衡量时，基因与应激在自杀未遂方面的相互作用提供了初步证据。自杀研究的进展可能来自于在多种疾病中研究基因与症状相互作用假说的努力。
