Genetic and other risk factors for suicidal ideation and the relationship with depression
Genetic and other risk factors for suicidal ideation and the relationship with depression
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DOI：
10.1017/s0033291717000940
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发表时间：
2017-10-01
影响因子：
6.9
通讯作者：
Hotopf, M.
中科院分区：
文献类型：
--
作者：
Dutta, R.;Ball, H. A.;Hotopf, M.
背景有一个遗传的贡献自杀的风险，但很少有以前的研究对自杀意念的遗传学。在斯里兰卡基于人口的双胞胎登记处（n = 3906对双胞胎）和匹配的非双胞胎样本（n = 2016）中评估了主动和被动自杀意念。Logistic回归模型被用来检查与社会人口因素，环境暴露和精神症状的关联。采用结构方程模型对自杀意念的遗传度进行评估。任何自杀意念的终生患病率男性为13.0%（11.7-14.3%），女性为21.8%（20.3-23.2%），双胞胎和非双胞胎之间无显著差异。预测自杀意念的因素包括女性、终止婚姻关系、教育水平低、城市居住、年轻时失去父母、生活水平低和过去12个月内的压力性生活事件。自杀意念与抑郁症密切相关，但也与异常疲劳和酒精和烟草使用有关。最佳拟合结构方程模型表明，男性和女性的遗传因素（57%; CI 47-66）和非共享环境因素（43%; CI 34-53）都有很大贡献。在女性中，这种遗传成分主要是通过抑郁介导的，但在男性中，自杀意念有一个重要的遗传成分，独立于抑郁。这是第一个表明基因对自杀意念的贡献的结果，它独立于高收入国家以外的抑郁症。这些现象可能具有普遍性，因为以前的研究突出了斯里兰卡和高收入国家精神障碍病因之间的相似性。
Background. There is a genetic contribution to the risk of suicide, but sparse prior research on the genetics of suicidal ideation.Methods. Active and passive suicidal ideation were assessed in a Sri Lankan population-based twin registry (n = 3906 twins) and a matched non-twin sample (n = 2016). Logistic regression models were used to examine associations with socio-demographic factors, environmental exposures and psychiatric symptoms. The heritability of suicidal ideation was assessed using structural equation modelling.Results. The lifetime prevalence of any suicidal ideation was 13.0% (11.7-14.3%) for men; 21.8% (20.3-23.2%) for women, with no significant difference between twins and non-twins. Factors that predicted suicidal ideation included female gender, termination of marital relationship, low education level, urban residence, losing a parent whilst young, low standard of living and stressful life events in the preceding 12 months. Suicidal ideation was strongly associated with depression, but also with abnormal fatigue and alcohol and tobacco use. The best fitting structural equation model indicated a substantial contribution from genetic factors (57%; CI 47-66) and from non-shared environmental factors (43%; CI 34-53) in both men and women. In women this genetic component was largely mediated through depression, but in men there was a significant heritable component to suicidal ideation that was independent of depression.Conclusions. These are the first results to show a genetic contribution to suicidal ideation that is independent of depression outside of a high-income country. These phenomena may be generalizable, because previous research highlights similarities between the aetiology of mental disorders in Sri Lanka and higher-income countries.