Ohlis Anna, Li Lin, Kuja-Halkola Ralf, Lundström Sebastian, D'Onofrio Brian M, Hellner Clara, Lichtenstein Paul, Cederlöf Martin, Chang Zheng, Bjureberg Johan
Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Mol Psychiatry. 2025 Aug 22. doi: 10.1038/s41380-025-03165-z.
Nonsuicidal self-injury (NSSI) often temporally precedes suicide attempts (SA), and SA predicts suicide. The genetic and environmental aetiologies of the transition from NSSI to SA have not been studied. This study aims to investigate whether NSSI reported at age 18 influences the incidence of SA between ages 18 and 24, and to what extent these transitions from NSSI to SA are influenced by shared genetic and environmental factors. Twins born in Sweden were enrolled in this longitudinal population-based twin cohort study. Self-reports of NSSI and SA were collected at ages 18 and 24. The majority of individuals in the analytical sample (N = 3 934) were female (64.9%) and dizygotic twins (65.0%). We found that NSSI reported at age 18 was associated with an increased risk of SA between ages 18 and 24 (Odds Ratio 5.4, 95% CI 3.3-8.7), after adjusting for sex and childhood psychopathology. There was a strong genetic correlation between NSSI reported at age 18 and incidence of SA between ages 18 and 24 (rA=0.8, 95% CI 0.3-1.0). At age 18, the proportion of variance in NSSI explained by genetic factors was 53%, and the remaining variance was explained by non-shared environmental factors (47%). At age 24, genetic factors explained 30% of the variance in SA between ages 18 and 24, largely explained by shared genetic factors (66.6%) with NSSI reported at age 18. We found evidence that NSSI reported at age 18 had a strong genetic correlation with incidence of SA between ages 18 and 24.
非自杀性自伤（NSSI）通常在自杀未遂（SA）之前出现，且自杀未遂可预测自杀。从NSSI到SA转变的遗传和环境病因尚未得到研究。本研究旨在调查18岁时报告的NSSI是否会影响18至24岁之间SA的发生率，以及这些从NSSI到SA的转变在多大程度上受到共享遗传和环境因素的影响。瑞典出生的双胞胎被纳入了这项基于人群的纵向双胞胎队列研究。在18岁和24岁时收集了NSSI和SA的自我报告。分析样本中的大多数个体（N = 3934）为女性（64.9%）且是异卵双胞胎（65.0%）。我们发现，在调整了性别和儿童期精神病理学因素后，18岁时报告的NSSI与18至24岁之间SA风险增加相关（优势比5.4，95%置信区间3.3 - 8.7）。18岁时报告的NSSI与18至24岁之间SA的发生率之间存在很强的遗传相关性（rA = 0.8，95%置信区间0.3 - 1.0）。在18岁时，遗传因素解释了NSSI中53%的方差，其余方差由非共享环境因素解释（47%）。在24岁时，遗传因素解释了18至24岁之间SA中30%的方差，很大程度上由与18岁时报告的NSSI共享的遗传因素解释（66.6%）。我们发现有证据表明，18岁时报告的NSSI与18至二十4岁之间SA的发生率存在很强的遗传相关性。
