The Etiology of Risk: Alcohol and Drug Use Disorders and Suicidal Behavior

风险的病因学：酒精和药物滥用障碍以及自杀行为

• 批准号: 10380105
• 负责人: ALEXIS C EDWARDS
• 金额: $ 45.9万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-20 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10380105
• 关键词: Accounting; Address; Alcohol abuse; Alcohol consumption; Biometry; Cause of Death; Censuses; Cessation of life; Characteristics; Clinical Data; Collaborations; Communities; Complex; Data; Data Set; Development; Drug Use Disorder; Environment; Environmental Risk Factor; Epidemic; Epidemiologic Methods; Epidemiology; Etiology; Exposure to; Family; Family history of; Gender; Genetic; Genetic Risk; Goals; Healthcare; Individual; Influentials; Intervention; Investigation; Life Cycle Stages; Link; Longevity; Major Depressive Disorder; Measures; Mediating; Mediation; Medical; Mental disorders; Methodology; Modeling; Mood Disorders; Neighborhoods; Outcome; Pathway interactions; Persons; Pharmaceutical Preparations; Population Heterogeneity; Prevention; Process; Psychotic Disorders; Recording of previous events; Registries; Research; Research Design; Resources; Risk; Risk Assessment; Risk Behaviors; Risk Factors; Role; Sample Size; Sampling; Sex Differences; Statistical Methods; Statistical Models; Structure; Substance Use Disorder; Substance abuse problem; Suicide; Suicide attempt; Suicide prevention; Sweden; Testing; Visit; age effect; age group; alcohol risk; base; causal model; cohort; completed suicide; design; ethnic diversity; genetic epidemiology; health care service utilization; health care settings; high risk; improved; innovation; interest; mortality; novel; peer; power analysis; proband; psychiatric comorbidity; secondary analysis; sex; social epidemiology; sociodemographics; socioeconomics; substance misuse; suicidal behavior; suicidal risk; suicide rate; transmission process

Project Summary The current proposal seeks to clarify the mechanisms underlying observed associations between alcohol and drug use disorders (AUD and DUD, respectively; SUD collectively) and suicidal behaviors (SB), including suicide attempts and completions. The research team has an extensive history of productive collaborations, including, in particular, psychiatric and substance use disorder research. We have access to Swedish national registries including medical, criminal, census, family, and socioeconomic data for nearly 11 million individuals; these resources will be linked to create detailed datasets encompassing a wide range of risk factors at personal, familial, and environmental levels. We will utilize these resources to extend our prior research through our pursuit of four specific aims. The first aim is to clarify the extent to which AUD/DUD is related to risk of suicidal behavior, accounting for critical confounding factors such as psychiatric comorbidity. Using genetic epidemiologic methods in conjunction with other informative designs aimed at facilitating causal inference, we will address whether the observed association is attributable to confounders, causal processes, or both. Second, we will examine how familial AUD, DUD, and SB impact individual risk, disentangling genetic from environmental components of risk through novel study designs developed through our ongoing collaboration. Parallel analyses will examine the role of exposure to AUD, DUD, and SB in the non-familial environment. Third, we will dissect health care utilization among those with AUD/DUD to identify potential SB risk indicators, with two primary foci: i) timing of and reason for doctor visits, and ii) associations between psychiatric/SUD medication usage and outcomes. Finally, we will incorporate our findings from the first three specific aims into integrative etiologic models of risk, separately for suicide attempts and completions. These models will be structured in a developmentally informative manner and enable us to identify mediational processes among risk factors for both outcomes. Critically, Sweden and the US have highly comparable rates of suicidal behavior and share many characteristics, including an ethnically and socioeconomically diverse population; however, the US lacks registry resources comparable to those available in Sweden. We expect that the statistical power of these registries, in conjunction with the research team's extensive expertise in psychiatric and substance abuse research, social and genetic epidemiology, and causal modeling, will yield substantive findings on the relationship between AUD/DUD and SB, with important implications for improving our efforts at SB prevention and intervention.

项目摘要 目前的建议旨在澄清观察到的酒精与酒精之间联系的机制， 药物使用障碍（分别为AUD和DUD; SUD统称）和自杀行为（SB），包括自杀 尝试和完成。该研究团队有着广泛的富有成效的合作历史，包括， 特别是精神病和药物使用紊乱研究。我们可以进入瑞典国家登记处 包括近1100万人的医疗、犯罪、人口普查、家庭和社会经济数据; 资源将被链接，以创建详细的数据集，包括个人， 家庭和环境层面。我们将利用这些资源，通过我们的追求， 四个具体目标。第一个目的是澄清AUD/DUD与自杀行为风险的相关程度， 考虑到关键的混杂因素，如精神共病。使用遗传流行病学方法 结合其他旨在促进因果推理的信息设计，我们将讨论 观察到的关联可归因于混杂因素、因果过程或两者。其次，我们将研究如何 家族性AUD、DUD和SB影响个体风险，将遗传风险与环境风险分开 通过我们正在进行的合作开发的新研究设计。并行分析将检查 在非家庭环境中暴露于AUD、DUD和SB的作用。第三，我们将解剖医疗保健 在AUD/DUD患者中利用这些指标来识别潜在的SB风险指标，主要关注两个焦点：i）时机 和就诊原因，以及ii）精神病/SUD药物使用与结局之间的关联。 最后，我们将把前三个具体目标的发现纳入风险的综合病因学模型， 自杀未遂和自杀完成的数据这些模型将以一种发展性的 信息的方式，使我们能够确定两种结果的风险因素之间的中介过程。 重要的是，瑞典和美国的自杀行为率高度相似，并且有许多共同的特征， 包括种族和社会经济多样化的人口;然而，美国缺乏注册资源 与瑞典的同类产品相当。我们希望这些登记处的统计能力， 凭借研究团队在精神病学和药物滥用研究、社会和遗传学方面的广泛专业知识， 流行病学和因果模型，将产生实质性的结果之间的关系AUD/DUD和 SB，对改善我们在SB预防和干预方面的努力具有重要意义。

项目成果

Suicidal ideation during adolescence: The roles of aggregate genetic liability for suicide attempts and negative life events in the past year.

• DOI: 10.1111/jcpp.13653
• 发表时间: 2022-10
• 期刊: JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY
• 影响因子: 7.6
• 作者: Lannoy, Severine;Mars, Becky;Heron, Jon;Edwards, Alexis C.
• 通讯作者: Edwards, Alexis C.

Comparative risk of suicide by specific substance use disorders: A national cohort study.

• DOI: 10.1016/j.jpsychires.2021.10.017
• 发表时间: 2021-12
• 期刊: Journal of psychiatric research
• 影响因子: 4.8
• 作者: Crump C;Sundquist J;Kendler KS;Edwards AC;Sundquist K
• 通讯作者: Sundquist K

Risks of Depression and Suicide After Diagnosis With Heart Failure: A National Cohort Study.

• DOI: 10.1016/j.jchf.2022.07.007
• 发表时间: 2022-11
• 期刊: JACC-HEART FAILURE
• 影响因子: 13
• 作者: Crump, Casey;Sundquist, Jan;Kendler, Kenneth S.;Sieh, Weiva;Edwards, Alexis C.;Sundquist, Kristina
• 通讯作者: Sundquist, Kristina

Alcohol consumption and internalising disorders in young adults of ALSPAC: a population-based study.

• DOI: 10.1136/jech-2020-213922
• 发表时间: 2020-12
• 期刊: Journal of epidemiology and community health
• 影响因子: 6.3
• 作者: Fernandes GS;Lewis G;Hammerton G;Abeysekera K;Mahedy L;Edwards A;Lewis G;Hickman M;Heron J
• 通讯作者: Heron J

The Sources of Parent-Child Transmission of Risk for Suicide Attempt and Deaths by Suicide in Swedish National Samples.

• DOI: 10.1176/appi.ajp.2020.20010017
• 发表时间: 2020-10-01
• 期刊: The American journal of psychiatry
• 作者: Kendler KS;Ohlsson H;Sundquist J;Sundquist K;Edwards AC
• 通讯作者: Edwards AC