Dissecting Suicidality Using a Combined Genomic and Clinical Approach.
Dissecting Suicidality Using a Combined Genomic and Clinical Approach.
复制标题
使用基因组和临床相结合的方法剖析自杀。
DOI：
10.1038/npp.2016.228
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Le-Niculescu,Helen
中科院分区：
文献类型：
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作者：
Niculescu,AlexanderB;Le-Niculescu,Helen
-温斯顿·丘吉尔在全球每40个S中就有一个人自杀身亡，尽管自杀是一场潜在的可以预防的悲剧。显然，需要更好地评估、跟踪和预测自杀(意念、行为)。为此，我们努力开发更好的临床数据工具和客观的血液生物标记物。这两种方法是互补、协同的，可以相互启发。首先，在临床数据方面，我们基于已知的自杀危险因素苯酚(表型项)，开发了一个简单的多酚风险评分。与多基因评分类似，这些评分以二进制方式评分为0或1(不存在或存在)。这款名为自杀功能信息汇聚(CFI-S)的问卷/APP有22个简单易答的问题，涉及生活问题、心理健康、身体健康、环境压力、成瘾和文化因素。它故意不问自杀念头，因为这在大多数情况下都是一个沉重的问题，因为真正想自杀的人可能不会分享这些信息，因为他们害怕被阻止。CFI-S可以是自评，也可以是临床医生评分，从患者访谈中获得，也可以从近亲或病历中获得。CFI-S在男性(尼库列斯库等人，2015年)和女性(利维等人，2016年)中显示了对自杀意念和未来因自杀而住院的良好预测能力。它可以有一个治疗指导部分，因为它确定的风险因素中有一半以上是可以纠正的。此外，我们还开发并使用了一种简单的视觉模拟标尺类型的问卷/应用程序，称为Simple
–Winston Churchill One person dies by suicide every 40 s worldwide, despite suicide being a potentially preventable tragedy. It is clear that better assessment, tracking, and prediction of suicidality (ideation, actions) are needed. We endeavored to develop better clinical data tools and objective blood biomarkers for such purposes. The two approaches are complementary, synergistic, and can inform each other. First, in terms of clinical data, we developed a simple polyphenic risk score, based on phenes (phenotypic items) that are known risk factors for suicide. Similar to polygenic scoring, these were scored in a binary fashion as 0 or 1 (absent or present). This questionnaire/app, known as Convergent Functional Information for Suicide (CFI-S), has 22 easy-to-answer items, related to life issues, mental health, physical health, environmental stress, addictions, and cultural factors. It purposefully does not ask about suicidal ideation, as that is a loaded question in most settings, and because people who truly want to kill themselves may not share that information for fear of being stopped. CFI-S can be self-scored or clinician scored, obtained from patient interview, or from information from next of kin or medical records. CFI-S has shown good predictive ability for suicidal ideation and for future hospitalizations for suicidality, in men (Niculescu et al, 2015) and in women (Levey et al, 2016). It can have a therapy-guiding component, in that over half of the risk factors it identifies are correctable. In addition, we have developed and used a simple visual analog scale type of questionnaire/app, known as Simple