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Sun S, Liu Q, Wang Z, Huang YY, Sublette ME, Dwork AJ, Rosoklija G, Ge Y, Galfalvy H, Mann JJ, Haghighi F. Brain and blood transcriptome profiles delineate common genetic pathways across suicidal ideation and suicide. Mol Psychiatry 2024; 29:1417-1426. [PMID: 38278992 PMCID: PMC11189724 DOI: 10.1038/s41380-024-02420-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 01/28/2024]
Abstract
Human genetic studies indicate that suicidal ideation and behavior are both heritable. Most studies have examined associations between aberrant gene expression and suicide behavior, but behavior risk is linked to the severity of suicidal ideation. Through a gene network approach, this study investigates how gene co-expression patterns are associated with suicidal ideation and severity using RNA-seq data in peripheral blood from 46 live participants with elevated suicidal ideation and 46 with no ideation. Associations with the presence of suicidal ideation were found within 18 co-expressed modules (p < 0.05), as well as in 3 co-expressed modules associated with suicidal ideation severity (p < 0.05, not explained by severity of depression). Suicidal ideation presence and severity-related gene modules with enrichment of genes involved in defense against microbial infection, inflammation, and adaptive immune response were identified and investigated using RNA-seq data from postmortem brain that revealed gene expression differences with moderate effect sizes in suicide decedents vs. non-suicides in white matter, but not gray matter. Findings support a role of brain and peripheral blood inflammation in suicide risk, showing that suicidal ideation presence and severity are associated with an inflammatory signature detectable in blood and brain, indicating a biological continuity between ideation and suicidal behavior that may underlie a common heritability.
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Affiliation(s)
- Shengnan Sun
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- James J. Peters VA Medical Center, Bronx, NY, 10468, USA
| | - Qingkun Liu
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- James J. Peters VA Medical Center, Bronx, NY, 10468, USA
| | - Zhaoyu Wang
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- James J. Peters VA Medical Center, Bronx, NY, 10468, USA
| | - Yung-Yu Huang
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - M Elizabeth Sublette
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Andrew J Dwork
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Gorazd Rosoklija
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Yongchao Ge
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Hanga Galfalvy
- James J. Peters VA Medical Center, Bronx, NY, 10468, USA
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Fatemeh Haghighi
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
- James J. Peters VA Medical Center, Bronx, NY, 10468, USA.
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Bryan CJ, Butner JE, Tabares JV, Brown LA, Young-McCaughan S, Hale WJ, Litz BT, Yarvis JS, Fina BA, Foa EB, Resick PA, Peterson AL. A dynamical systems analysis of change in PTSD symptoms, depression symptoms, and suicidal ideation among military personnel during treatment for PTSD. J Affect Disord 2024; 350:125-132. [PMID: 38220099 DOI: 10.1016/j.jad.2024.01.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/11/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVE The connections among posttraumatic stress disorder (PTSD), depression, and suicidal ideation are elusive because of an overreliance on cross-sectional studies. In this secondary analysis of pooled data from three clinical trials of 742 military personnel, we examined the dynamic relationships among PTSD, depression, and suicidal ideation severity assessed repeatedly during and after outpatient treatment for PTSD. METHODS We conducted dynamical systems analyses to explore the potential for coordinated change over time in psychotherapy for PTSD. RESULTS Over the course of psychotherapy, PTSD, depression, and suicidal ideation severity changed in coordinated ways, consistent with an interdependent network. Results of eigenvalue decomposition analysis indicated the dominant change dynamic involved high stability and resistance to change but indicators of cycling were also observed, indicating participants "switched" between states that resisted change and states that promoted change. Depression (B = 0.48, SE = 0.11) and suicidal desire (B = 0.15, SE = 0.01) at a given assessment were associated with greater change in PTSD symptom severity at the next assessment. Suicidal desire (B = 0.001, SE < 0.001) at a given assessment was associated with greater change in depression symptom severity at the next assessment. Neither PTSD (B = -0.004, SE = 0.007) nor depression symptom severity (B = 0.000, SE = 0.001) was associated with subsequent change in suicidal ideation severity. CONCLUSIONS In a sample of treatment-seeking military personnel with PTSD, change in suicidal ideation and depression may precede change in PTSD symptoms but change in suicidal ideation was not preceded by change in PTSD or depression symptoms.
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Affiliation(s)
- Craig J Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University, United States of America; Center of Excellence for Suicide Prevention, Veterans Administration, Canandaigua, NY, United States of America.
| | - Jonathan E Butner
- Department of Psychology, The University of Utah, United States of America
| | - Jeffrey V Tabares
- Department of Psychiatry and Behavioral Health, The Ohio State University, United States of America
| | - Lily A Brown
- Department of Psychiatry, University of Pennsylvania, United States of America
| | - Stacey Young-McCaughan
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, United States of America
| | - Willie J Hale
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, United States of America; Department of Psychology, The University of Texas at San Antonio, United States of America
| | - Brett T Litz
- Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System, United States of America; Department of Psychiatry and Department of Psychological and Brain Sciences, Boston University
| | - Jeffrey S Yarvis
- Carl R. Darnall Army Medical Center, Fort Hood, TX, United States of America; Tulane University School of Social Work, New Orleans, LA, United States of America
| | - Brooke A Fina
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, United States of America
| | - Edna B Foa
- Department of Psychiatry, University of Pennsylvania, United States of America
| | - Patricia A Resick
- Department of Psychiatry and Behavioral Sciences, Duke Health, United States of America
| | - Alan L Peterson
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, United States of America; Department of Psychology, The University of Texas at San Antonio, United States of America; Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX, United States of America
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Sun S, Liu Q, Wang Z, Huang YY, Sublette M, Dwork A, Rosoklija G, Ge Y, Galfalvy H, Mann JJ, Haghighi F. Functional Architecture of Brain and Blood Transcriptome Delineate Biological Continuity Between Suicidal Ideation and Suicide. RESEARCH SQUARE 2023:rs.3.rs-2958575. [PMID: 37398042 PMCID: PMC10312911 DOI: 10.21203/rs.3.rs-2958575/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Human genetic studies indicate that suicidal ideation and behavior are both heritable. Most studies have examined associations between aberrant gene expression and suicide behavior, but behavior risk is linked to severity of suicidal ideation. Through a gene network approach, this study investigates how gene co-expression patterns are associated with suicidal ideation and severity using RNA-seq data in peripheral blood from 46 live participants with elevated suicidal ideation and 46 with no ideation. Associations with presence and severity of suicidal ideation were found within 18 and 3 co-expressed modules respectively (p < 0.05), not explained by severity of depression. Suicidal ideation presence and severity-related gene modules with enrichment of genes involved in defense against microbial infection, inflammation, and adaptive immune response were identified, and tested using RNA-seq data from postmortem brain that revealed gene expression differences in suicide decedents vs. non-suicides in white matter, but not gray matter. Findings support a role of brain and peripheral blood inflammation in suicide risk, showing that suicidal ideation presence and severity is associated with an inflammatory signature detectable in blood and brain, indicating a biological continuity between ideation and suicidal behavior that may underlie a common heritability.
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Rudd MD, Bryan CJ. Finding Effective and Efficient Ways to Integrate Research Advances Into the Clinical Suicide Risk Assessment Interview. Front Psychiatry 2022; 13:846244. [PMID: 35280175 PMCID: PMC8913708 DOI: 10.3389/fpsyt.2022.846244] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/02/2022] [Indexed: 11/27/2022] Open
Abstract
Research in clinical suicidology continues to rapidly expand, much of it with implications for day-to-day clinical practice. Clinicians routinely wrestle with how best to integrate recent advances into practice and how to do so in efficient and effective fashion. This article identifies five critical domains of recent research findings and offers examples of simple questions that can easily be integrated into a clinician's existing suicide risk assessment interview and related protocol helping inform the risk formulation process.
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Affiliation(s)
- M David Rudd
- Department of Psychology, University of Memphis, Memphis, TN, United States
| | - Craig J Bryan
- Department of Psychiatry and Behavioral Science, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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