Virginia Commonwealth University School of Medicine.
Lund University.
J Psychopathol Clin Sci. 2023 Feb;132(2):165-172. doi: 10.1037/abn0000802.
This study examined the extent to which the genetic and environmental characteristics of having a first versus a second suicide attempt (SA) are common or specific. We evaluated the direct pathway between these phenotypes and the role of specific risk factors. From Swedish national registries, two subsamples of individuals born between 1960 and 1980 were selected (1,227,287 twin-sibling pairs and 2,265,796 unrelated individuals). First, a twin-sibling model was fit to evaluate the genetic and environmental risk factors related to first and second SA. The model also included a direct path between first and second SA. Second, an extended Cox proportional hazards model (PWP) was used to evaluate the risk factors related to first versus second SA. In the twin-sibling model, suicide reattempt was strongly related to first SA (β = 0.72). The total heritability for the second SA was estimated at 0.48, with 45.80% unique to this second SA. The total environmental influence for the second SA was 0.51, with 50.59% unique. In the PWP model, we found that childhood environment, psychiatric disorders, and selected stressful life events were related to both first and second SA, potentially reflecting common genetic and environmental factors. Other stressful life events were associated with first but not second SA in the multivariable model, suggesting their specificity in explaining the first occurrence of SA but not its recurrence. Specific risk factors related to second SA need to be further explored. These findings have important implications for describing the pathways toward suicidal behavior and identifying individuals at risk for multiple SA. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
本研究旨在探讨首次和再次自杀尝试（SA）的遗传和环境特征在多大程度上具有共性或特异性。我们评估了这些表型之间的直接途径以及特定风险因素的作用。从瑞典国家登记处，选择了两个出生于 1960 年至 1980 年之间的个体亚样本（1,227,287 对双胞胎和 2,265,796 个无关个体）。首先，拟合了双胞胎模型，以评估与首次和再次 SA 相关的遗传和环境风险因素。该模型还包括首次和再次 SA 之间的直接路径。其次，使用扩展的 Cox 比例风险模型（PWP）来评估与首次与再次 SA 相关的风险因素。在双胞胎模型中，自杀再尝试与首次 SA 密切相关（β=0.72）。第二次 SA 的总遗传率估计为 0.48，其中 45.80%是第二次 SA 特有的。第二次 SA 的总环境影响为 0.51，其中 50.59%是第二次 SA 特有的。在 PWP 模型中，我们发现童年环境、精神障碍和选定的压力性生活事件与首次和再次 SA 均相关，这可能反映了共同的遗传和环境因素。其他压力性生活事件与首次 SA 相关，但与第二次 SA 无关，这表明它们在解释首次 SA 发生但不重复发生方面具有特异性。需要进一步探讨与第二次 SA 相关的特定风险因素。这些发现对于描述自杀行为的途径和识别多次 SA 的高危个体具有重要意义。（PsycInfo 数据库记录（c）2023 APA，保留所有权利）。
