Familial pathways to early-onset suicide attempt: a 5.6-year prospective study.
Familial pathways to early-onset suicide attempt: a 5.6-year prospective study.
复制标题
DOI：
10.1001/jamapsychiatry.2014.2141
复制
发表时间：
2015-02
期刊：
影响因子：
25.8
通讯作者：
Mann, John
中科院分区：
文献类型：
--
作者：
Brent, David A.;Melhem, Nadine M.;Oquendo, Maria;Burke, Ainsley;Birmaher, Boris;Stanley, Barbara;Biernesser, Candice;Keilp, John;Kolko, David;Ellis, Steve;Porta, Giovanna;Zelazny, Jamie;Iyengar, Satish;Mann, John
自杀企图是自杀的强烈预测因素，自杀是青少年死亡的主要原因。尽管家族传播的机制尚不清楚，但自杀企图具有高度家族性。更好地描述这些机制有助于制定潜在的预防目标。研究自杀行为从父母传播给孩子的机制和途径。在这项从1997年7月15日到2012年6月21日进行的前瞻性研究中，对334名临床转介的患有情绪障碍的先证者中总共701名10至50岁（平均年龄17.7岁）的后代进行了平均5.6年的随访，其中191名（57.2%）也曾尝试过自杀。主要结果是自杀未遂。在基线、中间时间点和接近尝试的时间点检查变量。通过结构化精神病学评估和自我报告以及对假设与家庭传播相关的领域（例如情绪障碍和冲动攻击）的访谈测量来对参与者进行评估。在 701 名后代中，44 名（6.3%）在参与研究之前曾尝试过自杀，29 名（4.1%）在研究随访期间尝试过自杀。多变量逻辑回归显示，先证者自杀企图是后代自杀企图的预测因素（比值比[OR]，4.79；95% CI，1.75-13.07），甚至控制了其他显着的后代变量：情绪障碍基线史（OR，4.20；95% CI，1.37-12.86）、自杀企图基线史（OR，5.69；95% CI，1.37-12.86）。 95% CI，1.94–16.74），以及尝试前时间点的情绪障碍（OR，11.32；95% CI，2.29–56.00）。路径分析与这些发现一致，揭示了先证者企图对后代自杀企图的直接影响，后代情绪障碍在每个时间点的强烈影响，以及冲动攻击作为情绪障碍的先兆。父母有自杀企图史表明，即使在调整了情绪障碍的家族传播因素后，有情绪障碍风险的后代自杀企图的几率也会增加近 5 倍。针对高危后代的情绪障碍和冲动攻击行为的干预措施可能会减少自杀行为的家族传播。
Suicide attempts are strong predictors of suicide, a leading cause of adolescent mortality. Suicide attempts are highly familial, although the mechanisms of familial transmission are not understood. Better delineation of these mechanisms could help frame potential targets for prevention. To examine the mechanisms and pathways by which suicidal behavior is transmitted from parent to child. In this prospective study conducted from July 15, 1997, through June 21, 2012, a total of 701 offspring aged 10 to 50 years (mean age, 17.7 years) of 334 clinically referred probands with mood disorders, 191 (57.2%) of whom had also made a suicide attempt, were followed up for a mean of 5.6 years. The primary outcome was a suicide attempt. Variables were examined at baseline, intermediate time points, and the time point proximal to the attempt. Participants were assessed by structured psychiatric assessments and self-report and by interview measures of domains hypothesized to be related to familial transmission (eg, mood disorder and impulsive aggression). Among the 701 offspring, 44 (6.3%) had made a suicide attempt before participating in the study, and 29 (4.1%) made an attempt during study follow-up. Multivariate logistic regression revealed that proband suicide attempt was a predictor of offspring suicide attempt (odds ratio [OR], 4.79; 95% CI, 1.75–13.07), even controlling for other salient offspring variables: baseline history of mood disorder (OR, 4.20; 95% CI, 1.37–12.86), baseline history of suicide attempt (OR, 5.69; 95% CI, 1.94–16.74), and mood disorder at the time point before the attempt (OR, 11.32; 95% CI, 2.29–56.00). Path analyses were consistent with these findings, revealing a direct effect of proband attempt on offspring suicide attempt, a strong effect of offspring mood disorder at each time point, and impulsive aggression as a precursor of mood disorder. Parental history of a suicide attempt conveys a nearly 5-fold increased odds of suicide attempt in offspring at risk for mood disorder, even after adjusting for the familial transmission of mood disorder. Interventions that target mood disorder and impulsive aggression in high-risk offspring may attenuate the familial transmission of suicidal behavior.
登录
查看更多内容
DOI：
10.1111/j.1469-7610.2012.02598.x
发表时间：
2012-11-01
影响因子：
7.6
作者：
Burke, Jeffrey D.
通讯作者：
Burke, Jeffrey D.
DOI：
10.1097/01.chi.0000135619.38392.78
发表时间：
2004-10-01
影响因子：
13.3
作者：
Brent, DA;Oquendo, M;Mann, JJ
通讯作者：
Mann, JJ
影响因子：
5.9
作者：
Compas, Bruce E.;Forehand, Rex;Roberts, Lorinda
通讯作者：
Roberts, Lorinda
影响因子：
17.7
作者：
Brent, DA;Oquendo, M;Mann, JJ
通讯作者：
Mann, JJ
DOI：
10.1111/j.1469-7610.2011.02448.x
发表时间：
2011-10-01
影响因子：
7.6
作者：
Hipwell, Alison E.;Stepp, Stephanie;Keenan, Kate
通讯作者：
Keenan, Kate