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Fiedorowicz JG, Merranko JA, Goldstein TR, Hower H, Iyengar S, Hafeman DM, Hunt JI, Strober M, Keller MB, Goldstein BI, Diler RS, Siddiqi S, Birmaher B. Validation of a youth suicide risk calculator in an adult sample with bipolar disorder. J Affect Disord 2024; 347:278-284. [PMID: 38007103 PMCID: PMC11022308 DOI: 10.1016/j.jad.2023.11.066] [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: 07/09/2023] [Revised: 11/08/2023] [Accepted: 11/18/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Bipolar disorder (BD) conveys the highest risk of suicide of all mental disorders. We sought to externally validate a risk calculator (RC) of suicide attempts developed in youth with BD from the Course and Outcome of Bipolar Youth (COBY) study in an adult sample. METHODS A prospective cohort of adults with BD from the National Institute of Mental Health Collaborative Depression Study (CDS; N = 427; mean (+/- SD) age at intake (36 +/- 13 years)) was secondarily analyzed to validate the COBY RC for one-year risk of suicide attempts/deaths. Nine of the ten predictor variables from the COBY RC were available in the CDS and used: age, age of mood disorder onset, first and second (partial) degree family history of suicide, history of psychotic symptoms, substance use disorder, prior suicide attempt, socioeconomic status, and non-suicidal self-injury (prospectively, incompletely at baseline). RESULTS Over a mean (SD) follow-up of 19 (10) years, 29 % of the CDS sample attempted suicide. The RC predicted suicide attempts/deaths over one-year follow-up with an area under the receiver operating characteristic curve (AUC) of 0.78 (95 % CI 0.75-0.80). The RC performed slightly better in those with a younger age of mood disorder onset. LIMITATIONS Clinical samples may limit generalizability; the RC does not assess more acute suicide risk. CONCLUSIONS One-year risk of suicide attempts/deaths can be predicted with acceptable accuracy in youth and adults with BD, comparable to commonly used RCs to predict cardiovascular risk. This RC may help identify higher-risk individuals with BD for personalized treatment and research. https://cobysuicideattemptsrc.shinyapps.io/Shiny.
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Affiliation(s)
- Jess G Fiedorowicz
- Departments of Psychiatry and Epidemiology, The University of Ottawa, 75 Laurier Ave. East, Ottawa, ON K1N 6N5, Canada.
| | - John A Merranko
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Tina R Goldstein
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Heather Hower
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA; Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA; Department of Psychiatry, University of California San Diego, 4510 Executive Drive, Suite 315, San Diego, CA 92121, USA
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, 230 S. Bouquet St., Pittsburgh, PA 15213, USA
| | - Danella M Hafeman
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Jeffrey I Hunt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA; Department of Psychiatry, Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI 02915, USA
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Martin B Keller
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA; Department of Psychiatry, University of Miami, 1120 NW 14(th) St., Miami, FL 33136, USA
| | - Benjamin I Goldstein
- Department of Psychiatry, CAMH, University of Toronto Faculty of Medicine, 2075 Bayview Ave., FG-53, Toronto, ON M4N-3M5, Canada
| | - Rasim S Diler
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Sara Siddiqi
- Departments of Psychiatry and Epidemiology, The University of Ottawa, 75 Laurier Ave. East, Ottawa, ON K1N 6N5, Canada
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
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Liu H, Wang L, Yu H, Chen J, Sun P. Polygenic Risk Scores for Bipolar Disorder: Progress and Perspectives. Neuropsychiatr Dis Treat 2023; 19:2617-2626. [PMID: 38050614 PMCID: PMC10693760 DOI: 10.2147/ndt.s433023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/05/2023] [Indexed: 12/06/2023] Open
Abstract
Bipolar disorder (BD) is a common and highly heritable psychiatric disorder, the study of BD genetic characteristics can help with early prevention and individualized treatment. At the same time, BD is a highly heterogeneous polygenic genetic disorder with significant genetic overlap with other psychiatric disorders. In recent years, polygenic risk scores (PRS) derived from genome-wide association studies (GWAS) data have been widely used in genetic studies of various complex diseases and can be used to explore the genetic susceptibility of diseases. This review discusses phenotypic associations and genetic correlations with other conditions of BD based on PRS, and provides ideas for genetic studies and prevention of BD.
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Affiliation(s)
- Huanxi Liu
- Qingdao Medical College, Qingdao University, Qingdao, 266071, People’s Republic of China
- Qingdao Mental Health Center, Qingdao, 266034, People’s Republic of China
| | - Ligang Wang
- Qingdao Mental Health Center, Qingdao, 266034, People’s Republic of China
| | - Hui Yu
- Qingdao Mental Health Center, Qingdao, 266034, People’s Republic of China
| | - Jun Chen
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Ping Sun
- Qingdao Mental Health Center, Qingdao, 266034, People’s Republic of China
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Mirza S, Docherty AR, Bakian A, Coon H, Soares JC, Walss-Bass C, Fries GR. Genetics and epigenetics of self-injurious thoughts and behaviors: Systematic review of the suicide literature and methodological considerations. Am J Med Genet B Neuropsychiatr Genet 2022; 189:221-246. [PMID: 35975759 PMCID: PMC9900606 DOI: 10.1002/ajmg.b.32917] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/26/2022] [Accepted: 07/26/2022] [Indexed: 02/01/2023]
Abstract
Suicide is a multifaceted and poorly understood clinical outcome, and there is an urgent need to advance research on its phenomenology and etiology. Epidemiological studies have demonstrated that suicidal behavior is heritable, suggesting that genetic and epigenetic information may serve as biomarkers for suicide risk. Here we systematically review the literature on genetic and epigenetic alterations observed in phenotypes across the full range of self-injurious thoughts and behaviors (SITB). We included 577 studies focused on genome-wide and epigenome-wide associations, candidate genes (SNP and methylation), noncoding RNAs, and histones. Convergence of specific genes is limited across units of analysis, although pathway-based analyses do indicate nervous system development and function and immunity/inflammation as potential underlying mechanisms of SITB. We provide suggestions for future work on the genetic and epigenetic correlates of SITB with a specific focus on measurement issues.
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Affiliation(s)
- Salahudeen Mirza
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), Houston, Texas, USA,Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
| | - Anna R. Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA,Huntsman Mental Health Institute, Salt Lake City, Utah, USA,Department of Psychiatry, The Virginia Commonwealth University, Richmond, Virginia, USA
| | - Amanda Bakian
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA,Huntsman Mental Health Institute, Salt Lake City, Utah, USA
| | - Hilary Coon
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA,Huntsman Mental Health Institute, Salt Lake City, Utah, USA
| | - Jair C. Soares
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), Houston, Texas, USA,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas, USA
| | - Consuelo Walss-Bass
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), Houston, Texas, USA,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas, USA
| | - Gabriel R. Fries
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), Houston, Texas, USA,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas, USA,Center for Precision Health, School of Biomedical Informatics, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
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Development of a Suicide Prediction Model for the Elderly Using Health Screening Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910150. [PMID: 34639457 PMCID: PMC8507921 DOI: 10.3390/ijerph181910150] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022]
Abstract
Suicide poses a serious problem globally, especially among the elderly population. To tackle the issue, this study aimed to develop a model for predicting suicide by using machine learning based on the elderly population. To obtain a large sample, the study used the big data health screening cohort provided by the National Health Insurance Sharing Service. By applying a machine learning technique, a predictive model that comprehensively utilized various factors was developed to select the elderly aged > 65 years at risk of suicide. A total of 48,047 subjects were included in the analysis. Individuals who died by suicide were older, and the number of men was significantly greater. The suicide group had a more prominent history of depression, with the use of medicaments significantly higher. Specifically, the prescription of benzodiazepines alone was associated with a high suicide risk. Furthermore, body mass index, waist circumference, total cholesterol, and low-density lipoprotein level were lower in the suicide group. We developed a model for predicting suicide by using machine learning based on the elderly population. This suicide prediction model can satisfy the performance to some extent by employing only the medical service usage behavior without subjective reports.
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