Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.
Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA.
Psychol Med. 2023 Mar;53(4):1639-1648. doi: 10.1017/S0033291721003354. Epub 2021 Sep 2.
How does genetic liability to suicide attempt (SA), suicide death (SD), major depression (MD), bipolar disorder (BD), schizophrenia (SZ), alcohol use disorder (AUD), and drug use disorder (DUD) impact on risk for SA and SD?
In the Swedish general population born 1932-1995 and followed through 2017 ( = 7 661 519), we calculate family genetic risk scores (FGRS) for SA, SD, MD, BD, SZ, AUD, and DUD. Registration for SA and SD was assessed from Swedish national registers.
In univariate and multivariate models predicting SA, FGRS were highest for SA, AUD, DUD, and MD. In univariate models predicting SD, the strongest FGRS were AUD, DUD, SA, and SD. In multivariate models, the FGRS for SA and AUD were higher in predicting SA while the FGRS for SD, BD, and SZ were higher in predicting SD. Higher FGRS for all disorders significantly predicted both younger age at first SA and frequency of attempts. For SD, higher FGRS for MD, AUD, and SD predicted later age at SD. Mediation of FGRS effects on SA and SD was more pronounced for SD than SA, strongest for AUD, DUD, and SZ FGRS and weakest for MD.
FGRS for both SA and SD and for our five psychiatric disorders impact on risk for SA and SD in a complex manner. While some of the impact of genetic risk factors for psychiatric disorders on risk for SA and SD is mediated through developing the disorders, these risks also predispose directly to suicidal behaviors.
自杀未遂（SA）、自杀死亡（SD）、重度抑郁症（MD）、双相情感障碍（BD）、精神分裂症（SZ）、酒精使用障碍（AUD）和药物使用障碍（DUD）的遗传易感性如何影响 SA 和 SD 的风险？
在瑞典出生于 1932 年至 1995 年且随访至 2017 年的一般人群（=7661519 人）中，我们计算了 SA、SD、MD、BD、SZ、AUD 和 DUD 的家族遗传风险评分（FGRS）。SA 和 SD 的登记是从瑞典国家登记处评估的。
在预测 SA 的单变量和多变量模型中，FGRS 最高的是 SA、AUD、DUD 和 MD。在预测 SD 的单变量模型中，最强的 FGRS 是 AUD、DUD、SA 和 SD。在多变量模型中，SA 和 AUD 的 FGRS 在预测 SA 方面更高，而 SD、BD 和 SZ 的 FGRS 在预测 SD 方面更高。所有疾病的 FGRS 越高，预测首次 SA 的年龄越小，尝试的频率越高。对于 SD，FGRS 对 MD、AUD 和 SD 的预测值越高，SD 的发病年龄越晚。FGRS 对 SA 和 SD 的影响的中介作用在 SD 中比在 SA 中更为明显，在 AUD、DUD 和 SZ 的 FGRS 中最强，在 MD 中最弱。
SA 和 SD 的 FGRS 以及我们的五种精神障碍对 SA 和 SD 的风险有复杂的影响。虽然精神障碍遗传风险因素对 SA 和 SD 风险的一些影响是通过发展这些障碍来介导的，但这些风险也直接导致自杀行为。
