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Schosser A, Butler AW, Ising M, Perroud N, Uher R, Ng MY, Cohen-Woods S, Craddock N, Owen MJ, Korszun A, Jones L, Jones I, Gill M, Rice JP, Maier W, Mors O, Rietschel M, Lucae S, Binder EB, Preisig M, Perry J, Tozzi F, Muglia P, Aitchison KJ, Breen G, Craig IW, Farmer AE, Müller-Myhsok B, McGuffin P, Lewis CM. Genomewide association scan of suicidal thoughts and behaviour in major depression. PLoS One 2011; 6:e20690. [PMID: 21750702 PMCID: PMC3130038 DOI: 10.1371/journal.pone.0020690] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 05/07/2011] [Indexed: 11/19/2022] Open
Abstract
Background Suicidal behaviour can be conceptualised as a continuum from suicidal ideation, to suicidal attempts to completed suicide. In this study we identify genes contributing to suicidal behaviour in the depression study RADIANT. Methodology/Principal Findings A quantitative suicidality score was composed of two items from the SCAN interview. In addition, the 251 depression cases with a history of serious suicide attempts were classified to form a discrete trait. The quantitative trait was correlated with younger onset of depression and number of episodes of depression, but not with gender. A genome-wide association study of 2,023 depression cases was performed to identify genes that may contribute to suicidal behaviour. Two Munich depression studies were used as replication cohorts to test the most strongly associated SNPs. No SNP was associated at genome-wide significance level. For the quantitative trait, evidence of association was detected at GFRA1, a receptor for the neurotrophin GDRA (p = 2e-06). For the discrete trait of suicide attempt, SNPs in KIAA1244 and RGS18 attained p-values of <5e-6. None of these SNPs showed evidence for replication in the additional cohorts tested. Candidate gene analysis provided some support for a polymorphism in NTRK2, which was previously associated with suicidality. Conclusions/Significance This study provides a genome-wide assessment of possible genetic contribution to suicidal behaviour in depression but indicates a genetic architecture of multiple genes with small effects. Large cohorts will be required to dissect this further.
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Affiliation(s)
- Alexandra Schosser
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Amy W. Butler
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
- Department of Psychiatry, University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Marcus Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Nader Perroud
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Rudolf Uher
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Mandy Y. Ng
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Sarah Cohen-Woods
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Nick Craddock
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Michael J. Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Ania Korszun
- Barts and The London Medical School, Queen Mary University of London, London, United Kingdom
| | - Lisa Jones
- Department of Psychiatry, Neuropharmacology and Neurobiology Section, University of Birmingham, Birmingham, United Kingdom
| | - Ian Jones
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Michael Gill
- Department of Psychiatry, Trinity Centre for Health Science, Dublin, Ireland
| | - John P. Rice
- Department of Psychiatry, Washington University, St. Louis, Missouri, United States of America
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Ole Mors
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
| | - Marcella Rietschel
- Division of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | | | | | - Martin Preisig
- University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - Julia Perry
- GlaxoSmithKline Research & Development, Stockley Park, United Kingdom
| | | | - Pierandrea Muglia
- GlaxoSmithKline Research & Development, Verona, Italy
- Department of Psychiatry, University of Toronto, Toronto, Canada
- NeuroSearch A/S, Ballerup, Denmark
| | - Katherine J. Aitchison
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Gerome Breen
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
- NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom
| | - Ian W. Craig
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Anne E. Farmer
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | | | - Peter McGuffin
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Cathryn M. Lewis
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
- * E-mail:
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Hamdan S, Melhem N, Orbach I, Farbstein I, El-Haib M, Apter A, Brent D. Risk factors for suicide attempt in an Arab kindred. J Affect Disord 2011; 132:247-53. [PMID: 21310495 PMCID: PMC3109187 DOI: 10.1016/j.jad.2011.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Revised: 01/07/2011] [Accepted: 01/13/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This explorative study examines correlates of suicidal behavior in an extended Arab kindred selected because of a high rate of suicidal behavior. METHODS Family members (n=468) aged 15 through 55 were assessed using a comprehensive structured psychiatric interview, the Composite International Diagnostic Interview (CIDI), which covers a wide range of psychopathology, including a spectrum of suicidal thoughts and behaviors. In addition, self-reported depression, anxiety, hopelessness, impulsivity and hostility, early childhood adversity, and suicidal behavior in first- and second-degree relatives were assessed. RESULTS Significant associations were found between suicidal thoughts and behavior, and the presence of family history of suicide, all forms of psychopathology and suicidal behaviors. In addition, impulsivity and hostility were also significantly associated with suicidality. LIMITATION The absence of similar assessments in comparison families, makes it difficult to assess why this family appears to be at higher risk for suicidal behavior. CONCLUSION Risk correlates of suicidal behavior in the Arab kindred are similar to those reported from other parts of the world. These findings suggest that effective means of suicide prevention used in European populations may be successfully adapted to prevent suicide in this ethnic group as well. Since all forms of suicidal behavior in this population as well as in other Arab populations are increasing rapidly (Karam et al., 2008), these results have important implications for suicide prevention as well as for the understanding of the genetics of suicide.
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Affiliation(s)
- Sami Hamdan
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States.
| | - Nadine Melhem
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Ilana Farbstein
- Department of Child and Adolescent Psychiatry, Ziv Hospital, Safed, Israel
| | | | - Alan Apter
- Schneider Children's Medical Center, Israel
| | - David Brent
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
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Gonda X, Fountoulakis KN, Harro J, Pompili M, Akiskal HS, Bagdy G, Rihmer Z. The possible contributory role of the S allele of 5-HTTLPR in the emergence of suicidality. J Psychopharmacol 2011; 25:857-66. [PMID: 20837566 DOI: 10.1177/0269881110376693] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Suicide is a complex and challenging human phenomenon, and, although knowledge is expanding concerning its risk factors, its background is still not fully understood. There is currently an increasing interest in genetic factors associated with suicide, since these may lead to the emergence of personality traits and temperaments that may be long-term predictors of suicidal behaviour. One of the most likely genetic candidates in the background of suicide is the 5-HTTLPR polymorphism of the serotonin transporter gene. This review focused on papers published on the association of the 5-HTTLPR polymorphism of the serotonin transporter gene and suicidal behaviour as well as research on possible endophenotypes related to suicide. Although there are contradictory results, several studies and meta-analyses support the idea that the S allele plays a role in the background of violent suicide. However, in order to be able to delineate the genetic background of suicide, different types of suicidal behaviour should be distinguished, since studies indicate that these may have different genetic factors. Also, personality traits and temperaments should be identified that may play a modulating role between genetic factors and suicidal behaviour. So far, neuroticism, affective temperaments, and impulsive aggression have been found to be associated with both the S allele and suicidal behaviour. This study aimed to integrate findings concerning possible endophenotypes modulating between genetic factors and manifested suicidal behaviour.
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Affiliation(s)
- Xenia Gonda
- Department of Pharmacodynamics, Semmelweis University, Faculty of Medicine, Budapest, Hungary.
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Tsai SJ, Hong CJ, Liou YJ. Recent molecular genetic studies and methodological issues in suicide research. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:809-17. [PMID: 20977922 DOI: 10.1016/j.pnpbp.2010.10.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 10/17/2010] [Accepted: 10/17/2010] [Indexed: 12/16/2022]
Abstract
Suicide behavior (SB) spans a spectrum ranging from suicidal ideation to suicide attempts and completed suicide. Strong evidence suggests a genetic susceptibility to SB, including familial heritability and common occurrence in twins. This review addresses recent molecular genetic studies in SB that include case-control association, genome gene-expression microarray, and genome-wide association (GWA). This work also reviews epigenetics in SB and pharmacogenetic studies of antidepressant-induced suicide. SB fulfills criteria for a complex genetic phenotype in which environmental factors interact with multiple genes to influence susceptibility. So far, case-control association approaches are still the mainstream in SB genetic studies, although whole genome gene-expression microarray and GWA studies have begun to emerge in recent years. Genetic association studies have suggested several genes (e.g., serotonin transporter, tryptophan hydroxylase 2, and brain-derived neurotrophic factor) related to SB, but not all reports support these findings. The case-control approach while useful is limited by present knowledge of disease pathophysiology. Genome-wide studies of gene expression and genetic variation are not constrained by our limited knowledge. However, the explanatory power and path to clinical translation of risk estimates for common variants reported in genome-wide association studies remain unclear because of the presence of rare and structural genetic variation. As whole genome sequencing becomes increasingly widespread, available genomic information will no longer be the limiting factor in applying genetics to clinical medicine. These approaches provide exciting new avenues to identify new candidate genes for SB genetic studies. The other limitation of genetic association is the lack of a consistent definition of the SB phenotype among studies, an inconsistency that hampers the comparability of the studies and data pooling. In summary, SB involves multiple genes interacting with non-genetic factors. A better understanding of the SB genes by combining whole genome approaches with case-control association studies, may potentially lead to developing effective screening, prevention, and management of SB.
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Affiliation(s)
- Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
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Courtet P, Gottesman II, Jollant F, Gould TD. The neuroscience of suicidal behaviors: what can we expect from endophenotype strategies? Transl Psychiatry 2011; 1. [PMID: 21761009 PMCID: PMC3134241 DOI: 10.1038/tp.2011.6] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Vulnerability to suicidal behavior (SB) is likely mediated by an underlying genetic predisposition interacting with environmental and probable epigenetic factors throughout the lifespan to modify the function of neuronal circuits, thus rendering an individual more likely to engage in a suicidal act. Improving our understanding of the neuroscience underlying SBs, both attempts and completions, at all developmental stages is crucial for more effective preventive treatments and for better identification of vulnerable individuals. Recent studies have characterized SB using an endophenotype strategy, which aims to identify quantitative measures that reflect genetically influenced stable changes in brain function. In addition to aiding in the functional characterization of susceptibility genes, endophenotypic research strategies may have a wider impact in determining vulnerability to SB, as well as the translation of human findings to animal models, and vice versa. Endophenotypes associated with vulnerability to SB include impulsive/aggressive personality traits and disadvantageous decision making. Deficits in realistic risk evaluation represent key processes in vulnerability to SB. Serotonin dysfunction, indicated by neuroendocrine responses and neuroimaging, is also strongly implicated as a potential endophenotype and is linked with impulsive aggression and disadvantageous decision making. Specific endophenotypes may represent heritable markers for the identification of vulnerable patients and may be relevant targets for successful suicide prevention and treatments.
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Affiliation(s)
- P Courtet
- Department of Emergency Psychiatry, CHRU Montpellier, Inserm U1061, University of Montpellier I, Montpellier, France
| | - I I Gottesman
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA,Department Psychology, University of Minnesota, Minneapolis, MN, USA
| | - F Jollant
- Douglas Mental Health University Institute, McGill Group for Suicide Studies, McGill University, Montreal, Quebec, Canada
| | - T D Gould
- Departments of Psychiatry, and Pharmacology and Experimental Therapeutics, University of Maryland School of Medicine, Baltimore, MD, USA,Department of Psychiatry, and Pharmacology and Experimental Therapeutics, University of Maryland School of Medicine, Room 934D MSTF, 685 West Baltimore Street, Baltimore, MD 21201, USA. E-mail:
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The association between brain-derived neurotrophic factor polymorphism (BDNF Val66Met) and suicide. J Affect Disord 2011; 128:287-90. [PMID: 20667416 DOI: 10.1016/j.jad.2010.07.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2010] [Revised: 05/21/2010] [Accepted: 07/01/2010] [Indexed: 01/12/2023]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) mediates neural plasticity, mood, different behaviours, and stress response. A functional BDNF polymorphism (BDNF Val66Met) was reported to influence the effects of stressful life events or childhood adversity on depression and suicidal behaviour in various psychopathologies. The study evaluated the association between BDNF Val66Met variants and suicide, committed with violent or non-violent methods, in victims with or without stressful childhood experience. METHODS BDNF Val66Met polymorphism was genotyped on 560DNA samples from 359 suicide victims and 201 control subjects collected on autopsy from unrelated Caucasian subjects and subdivided according to gender, method of suicide, and influence of childhood adversity. RESULTS A similar frequency of BDNF Val66Met variants was found between all included suicide victims and the control groups, and also between the male groups. The frequency of the combined Met/Met and Met/Val genotypes and the homozygous Val/Val genotype was significantly different between the female suicide victims and female controls, between the female suicide victims who used violent suicide methods and female controls, and between all included suicide victims with or without stressful life events. The combined Met/Met and Met/Val genotypes contributed to this significance. LIMITATION A small group of suicide victims with available data on childhood adversity was studied. CONCLUSIONS The combined Met/Met and Met/Val genotypes of the BDNF Val66Met variant could be the risk factor for violent suicide in female subjects and for suicide in victims exposed to childhood trauma. These results confirm a major role of BDNF in increased vulnerability to suicide.
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Perlis RH, Huang J, Purcell S, Fava M, Rush AJ, Sullivan PF, Hamilton SP, McMahon FJ, Schulze TG, Schulze T, Potash JB, Zandi PP, Willour VL, Penninx BW, Boomsma DI, Vogelzangs N, Middeldorp CM, Rietschel M, Nöthen M, Cichon S, Gurling H, Bass N, McQuillin A, Hamshere M, Craddock N, Sklar P, Smoller JW. Genome-wide association study of suicide attempts in mood disorder patients. Am J Psychiatry 2010; 167:1499-507. [PMID: 21041247 PMCID: PMC3795390 DOI: 10.1176/appi.ajp.2010.10040541] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Family and twin studies suggest that liability for suicide attempts is heritable and distinct from mood disorder susceptibility. The authors therefore examined the association between common genomewide variation and lifetime suicide attempts. METHOD The authors analyzed data on lifetime suicide attempts from genomewide association studies of bipolar I and II disorder as well as major depressive disorder. Bipolar disorder subjects were drawn from the Systematic Treatment Enhancement Program for Bipolar Disorder cohort, the Wellcome Trust Case Control Consortium bipolar cohort, and the University College London cohort. Replication was pursued in the NIMH Genetic Association Information Network bipolar disorder project and a German clinical cohort. Depression subjects were drawn from the Sequential Treatment Alternatives to Relieve Depression cohort, with replication in the Netherlands Study of Depression and Anxiety/Netherlands Twin Register depression cohort. RESULTS Strongest evidence of association for suicide attempt in bipolar disorder was observed in a region without identified genes (rs1466846); five loci also showed suggestive evidence of association. In major depression, strongest evidence of association was observed for a single nucleotide polymorphism in ABI3BP, with six loci also showing suggestive association. Replication cohorts did not provide further support for these loci. However, meta-analysis incorporating approximately 8,700 mood disorder subjects identified four additional regions that met the threshold for suggestive association, including the locus containing the gene coding for protein kinase C-epsilon, previously implicated in models of mood and anxiety. CONCLUSIONS The results suggest that inherited risk for suicide among mood disorder patients is unlikely to be the result of individual common variants of large effect. They nonetheless provide suggestive evidence for multiple loci, which merit further investigation.
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Affiliation(s)
- Roy H Perlis
- Department of Psychiatry, Massachusetts General Hospital, Boston, 02114, USA.
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Fiori LM, Wanner B, Jomphe V, Croteau J, Vitaro F, Tremblay RE, Bureau A, Turecki G. Association of polyaminergic loci with anxiety, mood disorders, and attempted suicide. PLoS One 2010; 5:e15146. [PMID: 21152090 PMCID: PMC2994870 DOI: 10.1371/journal.pone.0015146] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Accepted: 10/26/2010] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The polyamine system has been implicated in a number of psychiatric conditions, which display both alterations in polyamine levels and altered expression of genes related to polyamine metabolism. Studies have identified associations between genetic variants in spermidine/spermine N1-acetyltransferase (SAT1) and both anxiety and suicide, and several polymorphisms appear to play important roles in determining gene expression. METHODOLOGY/PRINCIPAL FINDINGS We genotyped 63 polymorphisms, spread across four polyaminergic genes (SAT1, spermine synthase (SMS), spermine oxidase (SMOX), and ornithine aminotransferase like-1 (OATL1)), in 1255 French-Canadian individuals who have been followed longitudinally for 22 years. We assessed univariate associations with anxiety, mood disorders, and attempted suicide, as assessed during early adulthood. We also investigated the involvement of gene-environment interactions in terms of childhood abuse, and assessed internalizing and externalizing symptoms as endophenotypes mediating these interactions. Overall, each gene was associated with at least one main outcome: anxiety (SAT1, SMS), mood disorders (SAT1, SMOX), and suicide attempts (SAT1, OATL1). Several SAT1 polymorphisms displayed disease-specific risk alleles, and polymorphisms in this gene were involved in gene-gene interactions with SMS to confer risk for anxiety disorders, as well as gene-environment interactions between childhood physical abuse and mood disorders. Externalizing behaviors demonstrated significant mediation with regards to the association between OATL1 and attempted suicide, however there was no evidence that externalizing or internalizing behaviors were appropriate endophenotypes to explain the associations with mood or anxiety disorders. Finally, childhood sexual abuse did not demonstrate mediating influences on any of our outcomes. CONCLUSIONS/SIGNIFICANCE These results demonstrate that genetic variants in polyaminergic genes are associated with psychiatric conditions, each of which involves a set of separate and distinct risk alleles. As several of these polymorphisms are associated with gene expression, these findings may provide mechanisms to explain the alterations in polyamine metabolism which have been observed in psychiatric disorders.
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Affiliation(s)
- Laura M. Fiori
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Brigitte Wanner
- Research Unit on Children's Psychosocial Maladjustment, Université de Montréal, Montreal, Quebec, Canada
| | - Valérie Jomphe
- Centre de recherche Université Laval Robert-Giffard, Université Laval, Quebec City, Quebec, Canada
| | - Jordie Croteau
- Centre de recherche Université Laval Robert-Giffard, Université Laval, Quebec City, Quebec, Canada
| | - Frank Vitaro
- Research Unit on Children's Psychosocial Maladjustment, Université de Montréal, Montreal, Quebec, Canada
| | - Richard E. Tremblay
- Research Unit on Children's Psychosocial Maladjustment, Université de Montréal, Montreal, Quebec, Canada
- School of Public Health and Population Sciences, University College Dublin, Dublin, Ireland
| | - Alexandre Bureau
- Centre de recherche Université Laval Robert-Giffard, Université Laval, Quebec City, Quebec, Canada
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
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Wortzel HS, Gutierrez PM, Homaifar BY, Breshears RE, Harwood JE. Surrogate endpoints in suicide research. Suicide Life Threat Behav 2010; 40:500-5. [PMID: 21034212 DOI: 10.1521/suli.2010.40.5.500] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Surrogate endpoints frequently substitute for rare outcomes in research. The ability to learn about completed suicides by investigating more readily available and proximate outcomes, such as suicide attempts, has obvious appeal. However, concerns with surrogates from the statistical science perspective exist, and mounting evidence from psychometric, neurochemical, genetic, and neuroimaging studies suggests that surrogates may be particularly problematic in suicide research. The need for greater phenotypic refinement of suicide-related behaviors, development of and adherence to a shared suicide nomenclature, and conservative interpretation of investigational results that are limited to the precise population and suicide-related behavior under examination are discussed.
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Affiliation(s)
- Hal S Wortzel
- VISN 19 MIRECC, Denver VA Medical Center, Denver, CO 80220, USA.
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Giegling I, Chiesa A, Mandelli L, Gibiino S, Hartmann AM, Möller HJ, Schneider B, Schnabel A, Maurer K, De Ronchi D, Rujescu D, Serretti A. Influence of neuronal cell adhesion molecule (NCAM1) variants on suicidal behaviour and correlated traits. Psychiatry Res 2010; 179:222-5. [PMID: 20483466 DOI: 10.1016/j.psychres.2009.03.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2008] [Revised: 02/13/2009] [Accepted: 03/19/2009] [Indexed: 11/19/2022]
Abstract
Suicide is a public health problem all around the world. Family studies showed a strong heritability but, to date, few genetic data are available. Thus, in the present study we investigated whether a panel of single nucleotide polymorphisms (SNPs) in neuronal cell adhesion molecule 1 (NCAM) 1 was associated with suicidal behaviour as well as specific traits related to suicide. A total of two hundred and fifty-nine individuals with a positive history of suicidal behaviour and 312 healthy subjects were enrolled in the study. Rs2301228, rs1884, rs1245113, rs1369816, rs2196456 and rs584427 in NCAM1 were genotyped. No marker was significantly associated with suicidal behaviour vs. controls or with sub-types of attempted vs. completed, violent vs. non-violent, impulsive vs. non-impulsive suicide. Nonetheless rs1884 and rs2196456 SNPs were both marginally associated with the trait "inhibition of aggressiveness" in suicide attempters. Even though the investigated SNPs in NCAM1 do not seem to be directly associated with suicidal behaviour, our results could suggest that SNP variants in NCAM1 may impact on related traits, particularly by mediating inhibition of aggressiveness. However, independent studies are needed to validate these results.
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Affiliation(s)
- Ina Giegling
- Department of Psychiatry, Ludwig Maximilians University, Munich, Germany
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Zhang Y, Zhang C, Yuan G, Yao J, Cheng Z, Liu C, Liu Q, Wan G, Shi G, Cheng Y, Ling Y, Li K. Effect of tryptophan hydroxylase-2 rs7305115 SNP on suicide attempts risk in major depression. Behav Brain Funct 2010; 6:49. [PMID: 20738857 PMCID: PMC2939585 DOI: 10.1186/1744-9081-6-49] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 08/25/2010] [Indexed: 02/01/2023] Open
Abstract
Background Suicide and major depressive disorders (MDD) are strongly associated, and genetic factors are responsible for at least part of the variability in suicide risk. We investigated whether variation at the tryptophan hydroxylase-2 (TPH2) gene rs7305115 SNP may predispose to suicide attempts in MDD. Methods We genotyped TPH2 gene rs7305115 SNP in 215 MDD patients with suicide and matched MDD patients without suicide. Differences in behavioral and personality traits according to genotypic variation were investigated by logistic regression analysis. Results There were no significant differences between MDD patients with suicide and controls in genotypic (AG and GG) frequencies for rs7305115 SNP, but the distribution of AA genotype differed significantly (14.4% vs. 29.3%, p < 0.001). The G-allele frequency was significantly higher in cases than control group (58.1% vs.45.6%, p < 0.001), but the A-allele carrier indicated a decreased trend in MDD with suicide behaviors than control group (41.9% vs.54.4%, p < 0.001). The multivariate logistic regression analysis indicated that TPH2 rs7305115 AA (OR 0.33, 95% CI 0.22-0.99), family history of suicide (OR 2.98, 95% CI 1.17-5.04), negative life events half year ago (OR 6.64, 95% CI 2.48-11.04) and hopelessness (OR 7.68, 95% CI 5.79-13.74) were significantly associated with the suicide behaviors in MDD patients. Conclusions The study suggested that hopelessness, negative life events and family history of suicide were risk factors of attempted suicide in MDD while the TPH2 rs7305115A remained a significant protective predictor of suicide attempts.
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Affiliation(s)
- Yuqi Zhang
- Wuxi Psychiatric Hospital, Nanjing Medical University, Wuxi, China.
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Mahon PB, Stütz AM, Seifuddin F, Huo Y, Goes FS, Jancic D, Judy JT, Depaulo JR, Gershon ES, McMahon FJ, Zandi PP, Potash JB, Willour VL. Case-control association study of TGOLN2 in attempted suicide. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:1016-23. [PMID: 20468057 PMCID: PMC3645851 DOI: 10.1002/ajmg.b.31068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Family, twin, and adoption studies provide convincing evidence for a genetic contribution to suicidal behavior. The heritability for suicidal behavior depends in part on the transmission of psychiatric disorders, such as mood disorders and substance use disorders, but is also partly independent of them. Three linkage studies using the attempted suicide phenotype in pedigrees with bipolar disorder, major depression, or alcoholism have provided consistent evidence that 2p11-12 harbors a susceptibility gene for attempted suicide. A microarray expression study using postmortem brain samples has implicated a gene from the 2p11-12 candidate region, the trans-Golgi network protein 2 (TGOLN2) gene, as being consistently up-regulated in suicide cases as compared to controls. Here, we present a TGOLN2 case-control association study using nine single nucleotide polymorphisms (SNPs). These nine SNPs, which include seven tag SNPs and two coding SNPs, have been genotyped in 517 mood disorder subjects with a history of attempted suicide and 515 normal controls. Allelic and genotypic analyses of the case-control sample did not provide evidence for association with the attempted suicide phenotype. Eight of the nine SNPs provided supportive evidence for association (P-values ranging from 0.008 to 0.03) when we compared the attempted suicide cases with a history of alcoholism to the attempted suicide cases without a history of alcoholism. However, this association finding was not replicated in an independent sample. Taken together, these analyses do not provide support for the hypothesis that common genetic variation in TGOLN2 contributes significantly to the risk for attempted suicide in subjects with major mood disorders.
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Affiliation(s)
- Pamela B Mahon
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA
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Abstract
Advanced paternal age is a risk factor for adverse health outcomes in the offspring. In a population-based birth cohort from Finland, 10,965 singleton offspring born in 1966 and alive at age 1 were followed to age 39. Hazard ratios were calculated, adjusting for maternal age, gender, paternal social class, and maternal parity. In females but not in males, increasing paternal age was associated with a linear increased risk of suicide (hazard ratio [HR] = 1.13, 95% confidence interval [CI] = 1.04-1.24, p < 0.01) and all-causes mortality (HR = 1.06, 95% CI = 1.01-1.10, p = 0.02). Increasing maternal age was associated with a significantly decreased risk of suicide (HR = 0.93, 95% CI = 0.86-1.00, p = 0.04) and all-causes mortality (HR = 0.96, 95% CI = 0.93-1, p = 0.02) in the entire cohort. For paternal age >/=30, the population attributable risk percentage was 13.7% for all deaths and 7.5% for suicides. Parental age at birth may affect suicide and all-causes mortality risk in the offspring in the general population. The causal pathways and specific disorders associated with this increased mortality are largely unknown.
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65
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Labonte B, Turecki G. The epigenetics of suicide: explaining the biological effects of early life environmental adversity. Arch Suicide Res 2010; 14:291-310. [PMID: 21082447 DOI: 10.1080/13811118.2010.524025] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A number of recent studies have shown epigenetic alterations associated with suicidal behavior. These epigenetic mechanisms, which alter gene expression via alternative mechanisms to the coding DNA sequence, result from environmental effects acting on the genome. Studies in rodents indicate that variation in the early environment will trigger these epigenetic modifications and recent human data suggest the same may be true in humans.The expression of a number of genes, which are involved in normal brain functions and that have been shown to be under epigenetic control, seem to be dysregulated in suicide. The present review briefly describes the main epigenetic mechanisms involved in the regulation of gene expression and discusses recent findings of epigenetic alterations in suicidal behavior.
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Affiliation(s)
- Benoit Labonte
- Douglas Hospital, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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66
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Neuronal tryptophan hydroxylase (TPH2) in suicidal behaviour. Transl Neurosci 2010. [DOI: 10.2478/v10134-010-0031-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractSerotonin (5-hydroxytryptamine, 5-HT) is a signalling molecule involved in many brain functions as well as in a variety of psychiatric conditions, including suicidal behaviour. Tryptophan hydroxylase (TPH), the rate-limiting enzyme of 5-HT biosynthesis, plays a critical role in 5-HT metabolism and thus in the regulation of 5-HT neurotransmission. There are two isoforms of TPH, so-called peripheral (TPH1) and neuronal (TPH2), encoded by the two distinct genes. TPH1 is abundant in the peripheral tissues, while TPH2 was detected exclusively within the nervous system. Since its discovery in 2003, TPH2 gene has attracted great interest as a potential factor contributing to diathesis of suicidal behaviour. However, initial positive findings indicating an association of TPH2 genetic variants with suicide have not been replicated consistently. Here we provide an overview of published studies to date, that have evaluated the contribution of TPH2 gene to the etiopathogenesis of suicidal behaviour.
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Azenha D, Alves M, Matos R, Santa JF, Silva B, Cordeiro C, Vieira DN, Ambrósio AM. Male specific association between the 5-HTR6 gene 267C/T SNP and suicide in the Portuguese population. Neurosci Lett 2009; 466:128-30. [PMID: 19782122 DOI: 10.1016/j.neulet.2009.09.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 09/06/2009] [Accepted: 09/21/2009] [Indexed: 10/20/2022]
Abstract
Serotonergic system dysfunction has been implicated in the etiology of suicide. A large number of genetic studies have focused on the potential involvement of genes coding for components of serotonergic system in suicidal behavior. However, other genes belonging to this system remain to be investigated or have been poorly studied, as is the case of the 5-HT6 receptor (5-HTR6) gene. In this study, we investigated the potential association between the 5-HTR6 gene 267C/T SNP and suicide in a Portuguese population. Blood samples were collected from 179 suicide victims and 189 controls. Genotypes for the 5-HTR6 gene 267C/T SNP were obtained with the restriction enzyme Rsa I. A tendency was found for genotype association between this polymorphism and suicide, but the differences were not statistically significant (chi(2)=5.374, df=2, p=0.068). However, a gender-specific association was detected when comparing the genotype distribution between male suicide victims and male controls (chi(2)=6.988, df=2, p=0.030), suggesting that this SNP might have a role in the etiology of suicide in male subjects in the Portuguese population.
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Affiliation(s)
- Diana Azenha
- Clinical and Molecular Genetics Unit, National Institute of Legal Medicine, Coimbra, Portugal
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68
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Cicchetti D, Rogosch FA, Sturge-Apple M, Toth SL. Interaction of child maltreatment and 5-HTT polymorphisms: suicidal ideation among children from low-SES backgrounds. J Pediatr Psychol 2009; 35:536-46. [PMID: 19779024 DOI: 10.1093/jpepsy/jsp078] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To investigate whether genotypic variation of the serotonin transporter gene-linked promoter region (5-HTTLPR) moderates the effect of maltreatment on suicidal ideation in school-aged children. METHODS Eight hundred and fifty low-income children (478 maltreated; 372 non-maltreated) provided DNA samples and self-reported depressive and suicidal symptoms. Genotypes of 5-HTTLPR (s/s or s/l vs. l/l) were determined by fragment analyses. RESULTS Higher suicidal ideation was found among maltreated than non-maltreated children; the groups did not differ in 5-HTTLPR genotype frequencies. Children with one to two maltreatment subtypes and s/s or s/l genotypes had higher suicidal ideation than those with the l/l genotype; suicidal ideation did not differ in non-maltreated children or children with three to four maltreatment subtypes based on 5-HTTLPR variation. The results were applicable to emotionally maltreated/neglected and to physically/sexually abused children. Gene-environment interaction was not found for depressive symptoms. CONCLUSION The protective effect of the 5-HTTLPR l/l genotype on suicidal ideation was limited to maltreated children experiencing fewer subtypes.
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Affiliation(s)
- Dante Cicchetti
- Institute of Child Development, University of Minnesota, 51 East River Road, Minneapolis, MN 55455, USA.
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Chachamovich E, Stefanello S, Botega N, Turecki G. [Which are the recent clinical findings regarding the association between depression and suicide?]. BRAZILIAN JOURNAL OF PSYCHIATRY 2009; 31 Suppl 1:S18-25. [PMID: 19565147 DOI: 10.1590/s1516-44462009000500004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Suicide is one of the leading causes of mortality worldwide, especially among young subjects. Suicide is considered the outcome of a multidimensional and complex phenomenon, which is a result of the interaction between several factors. The association between psychopathology and suicide has been extensively investigated. Major depression plays an important role among the psychiatric diagnoses associated with suicide. This finding seems to be confirmed by different study designs, and in distinct populations. The present paper aims to briefly review the recent findings regarding the suicide-related clinical features of depression. Moreover, strategies for suicide prevention were also reviewed. REVIEW Recent references were identified and grouped in order to illustrate the main contributions about depression and suicide. Briefly, the literature review stresses the high prevalence of major depression among subjects presenting suicide behaviors. Psychopathological traits, such as aggression and impulsivity play a relevant role in triggering suicidal behaviors. Strategies for suicide prevention were also reviewed in Brazil and internationally. In general, detection and treatment are effective in reducing suicide rates. CONCLUSION Studies regarding suicide behaviors have had a pragmatic approach, and generated a large body of evidence about correlates of suicide. However, these studies have not been able to provide a consistent theoretical explanation for this phenomenon. The recent adoption of modern strategies represents a possibility of enhancing the research capability of such studies. In order to be clinically useful, findings should make it possible to deepen the understanding over the experience of a suicidal person, as well as to design specific strategies for prevention and treatment in population subgroups.
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Affiliation(s)
- Eduardo Chachamovich
- McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, Canada
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Ernst C, Dumoulin P, Cabot S, Erickson J, Turecki G. SNAT1 and a family with high rates of suicidal behavior. Neuroscience 2009; 162:415-22. [DOI: 10.1016/j.neuroscience.2009.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2009] [Revised: 05/03/2009] [Accepted: 05/06/2009] [Indexed: 10/20/2022]
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Videtič A, Peternelj TT, Zupanc T, Balažic J, Komel R. Promoter and functional polymorphisms of HTR2C and suicide victims. GENES BRAIN AND BEHAVIOR 2009; 8:541-5. [DOI: 10.1111/j.1601-183x.2009.00505.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Saiz PA, Garcia-Portilla MP, Florez G, Arango C, Corcoran P, Morales B, Bascaran MT, Alvarez C, San Narciso G, Carreño E, Alvarez V, Coto E, Bobes J. Differential role of serotonergic polymorphisms in alcohol and heroin dependence. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33:695-700. [PMID: 19328219 DOI: 10.1016/j.pnpbp.2009.03.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 02/23/2009] [Accepted: 03/17/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND Twin studies suggest that genetic factors account for 40-60% of the variance in alcohol dependence. It has been stated that different drug dependencies may have unique genetic influences. Alterations in serotonin availability and function can affect drinking behaviour. This study aimed to investigate whether three serotonergic polymorphisms (HTR2A A-1438G (rs6311), and SCL6A4 5-HTTLPR and STin2 VNTR) were associated with alcohol dependence, and, whether the serotonergic polymorphisms played a similar role in conferring vulnerability in alcohol and heroin dependence. METHODS 165 alcohol dependent patients, 113 heroin dependent patients, and 420 healthy controls from a homogeneous Spanish Caucasian population were genotyped using standard methods. RESULTS Genotypic frequencies of the A-1438G, 5-HTTLPR, and STin2 VNTR polymorphisms did not differ significantly across the three groups. None of the three polymorphisms contributed to distinguishing alcoholic patients from healthy controls. There was an excess of -1438G and 5-HTTLPR L carriers in alcoholic patients in comparison to the heroin dependent group (OR (95% CI)=1.98 (1.13-3.45) and 1.92 (1.07-3.44), respectively). The A-1438G and 5-HTTLPR polymorphisms also interacted in distinguishing alcohol from heroin dependent patients (Wald (df)=10.21 (4), p=0.037). The association of -1438A/G with alcohol dependence was especially pronounced in the presence of 5-HTTLPR S/S, less evident with 5-HTTLPR L/S and not present with 5-HTTLPR L/L. SCL6A4 polymorphism haplotypes were similarly distributed in all three groups. CONCLUSIONS Our data do not support a role of serotonergic polymorphisms in alcohol dependence but suggest a differential genetic background to alcohol and heroin dependence.
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Affiliation(s)
- Pilar A Saiz
- Department of Psychiatry, School of Medicine, University of Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Julian Claveria 6, 33006, Oviedo, Spain.
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73
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Mann JJ, Arango VA, Avenevoli S, Brent DA, Champagne FA, Clayton P, Currier D, Dougherty DM, Haghighi F, Hodge SE, Kleinman J, Lehner T, McMahon F, Mościcki EK, Oquendo MA, Pandey GN, Pearson J, Stanley B, Terwilliger J, Wenzel A. Candidate endophenotypes for genetic studies of suicidal behavior. Biol Psychiatry 2009; 65:556-63. [PMID: 19201395 PMCID: PMC3271953 DOI: 10.1016/j.biopsych.2008.11.021] [Citation(s) in RCA: 263] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Revised: 10/21/2008] [Accepted: 11/12/2008] [Indexed: 12/12/2022]
Abstract
Twin, adoption, and family studies have established the heritability of suicide attempts and suicide. Identifying specific suicide diathesis-related genes has proven more difficult. As with psychiatric disorders in general, methodological difficulties include complexity of the phenotype for suicidal behavior and distinguishing suicide diathesis-related genes from genes associated with mood disorders and other suicide-associated psychiatric illness. Adopting an endophenotype approach involving identification of genes associated with heritable intermediate phenotypes, including biological and/or behavioral markers more proximal to genes, is an approach being used for other psychiatric disorders. Therefore, a workshop convened by the American Foundation for Suicide Prevention, the Department of Psychiatry at Columbia University, and the National Institute of Mental Health sought to identify potential target endophenotypes for genetic studies of suicidal behavior. The most promising endophenotypes were trait aggression/impulsivity, early-onset major depression, neurocognitive function, and cortisol social stress response. Other candidate endophenotypes requiring further investigation include serotonergic neurotransmission, second messenger systems, and borderline personality disorder traits.
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Affiliation(s)
- J John Mann
- Department of Psychiatry, NewYork State Psychiatric Institute/ColumbiaUniversity, 1051 Riverside Drive, New York, NY 10032, USA.
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Kovacsics CE, Gottesman II, Gould TD. Lithium's Antisuicidal Efficacy: Elucidation of Neurobiological Targets Using Endophenotype Strategies. Annu Rev Pharmacol Toxicol 2009; 49:175-98. [DOI: 10.1146/annurev.pharmtox.011008.145557] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Colleen E. Kovacsics
- Department of Psychiatry, Mood and Anxiety Disorders Program, University of Maryland School of Medicine, Baltimore, Maryland;
| | - Irving I. Gottesman
- Department of Psychiatry, University of Minnesota Medical School, and Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Todd D. Gould
- Department of Psychiatry, Mood and Anxiety Disorders Program, University of Maryland School of Medicine, Baltimore, Maryland;
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