scholarly journals Association between suicidal behavior and genes of serotonergic system confirmed in men with affective disorders

2014 ◽  
Vol 83 (1) ◽  
pp. 7-16
Author(s):  
Joanna Pawlak ◽  
Monika Dmitrzak-Węglarz ◽  
Maria Skibinska ◽  
Aleksandra Szczepankiewicz ◽  
Anna Leszczynska-Rodziewicz ◽  
...  
Keyword(s):  
Serotonin Transporter ◽  
Suicidal Behavior ◽  
Affective Disorders ◽  
Psychotic Disorders ◽  
Tryptophan Hydroxylase ◽  
Suicide Attempts ◽  
Clinical Problem ◽  
Serotonergic System ◽  
Type I ◽  
Nucleotide Polymorphisms

Introduction. Suicidal behavior is a crucial clinical problem in many groups of psychiatric patients. It occurs most often in affective disorders, psychotic disorders, substance abuse/dependence and personality disorders. Although not all patients with these diagnoses present suicidal behavior, it is very important to find the most vulnerable subgroups. The extensive number of studies shows that suicidal behavior (completed and attempted suicide) is associated with changes in functioning of serotonergic system. Tryptophan hydroxylase (TPH) is rate-limiting enzyme in biosynthesis of serotonin. Serotonin transporter (5-HTT) is the main factor removing serotonin from the synaptic space. Genetic studies confirm that suicide behavior has a genetic component independently of major psychiatric disorders. Aim. The aim of this study is to look for association between selected candidate genes and suicidal behavior in affective disorders.Material and methods. In the study we included 597 patients meeting DSM-IV criteria for bipolar disorder or unipolar disorder and 563 healthy controls. Polymorphism of serotonin transporter gene 5-HTTLPR and single nucleotide polymorphisms – SNPs (rs1799913 and rs1800532) in tryptophan hydroxylase 1 (TPH1) gene were analyzed. We used in computation Statistica 8.0 package (STATSOFT, Poland) (tests: The two-tailed Pearson's chi-square (?2) test and Fisher's exact test).Results. Main positive findings are an association between TPH1 polymorphisms and bipolar disease type I (BPI) diagnosis in men and an association between TPH1 polymorphisms and suicidal attempts in male patients. In all group we did not find nor allelic neither genotypic associations of selected polymorphisms and diagnosis or suicide attempts. Conclusions. Our findings partially confirm that serotonergic system plays a role in affective disorder and suicidal behavior, but the association needs further investigation.

scholarly journals Can Anhedonia Be Considered a Suicide Risk Factor? A Review of the Literature

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 458 ◽  
Author(s):  
Bonanni ◽  
Gualtieri ◽  
Lester ◽  
Falcone ◽  
Nardella ◽  
...  
Keyword(s):  
Suicidal Behavior ◽  
Affective Disorders ◽  
Suicide Attempts ◽  
Positive Association ◽  
Negative Association ◽  
Schizophrenia Spectrum Disorders ◽  
Post Traumatic Stress ◽  
Significant Positive Association ◽  
Search Terms ◽  
Schizophrenia Spectrum

Background and Objectives: At present, data collected from the literature about suicide and anhedonia are controversial. Some studies have shown that low levels of anhedonia are associated with serious suicide attempts and death by suicide, while other studies have shown that high levels of anhedonia are associated with suicide. Materials and Methods: For this review, we searched PubMed, Medline, and ScienceDirect for clinical studies published from 1 January 1990 to 31 December 2018 with the following search terms used in the title or in the abstract: “anhedonia AND suicid*.” We obtained a total of 155 articles; 133 items were excluded using specific exclusion criteria, the remaining 22 articles included were divided into six groups based on the psychiatric diagnosis: mood disorders, schizophrenia spectrum disorders, post-traumatic stress disorder (PTSD), other diagnoses, attempted suicides, and others (healthy subjects). Results: The results of this review reveal inconsistencies. Some studies reported that high anhedonia scores were associated with suicidal behavior (regardless of the diagnosis), while other studies found that low anhedonia scores were associated with suicidal behavior, and a few studies reported no association. The most consistent association between anhedonia and suicidal behavior was found for affective disorders (7 of 7 studies reported a significant positive association) and for PTSD (3 of 3 studies reported a positive association). In the two studies of patients with schizophrenia, one found no association, and one found a negative association. For patients who attempted suicide (undiagnosed), one study found a positive association, one a positive association only for depressed attempters, and one a negative association. Conclusions: We found the most consistent positive association for patients with affective disorders and PTSD, indicating that the assessment of anhedonia may be useful in the evaluation of suicidal risk.

scholarly journals Do risk factors for suicidal behavior differ by affective disorder polarity?

2008 ◽  
Vol 39 (5) ◽  
pp. 763-771 ◽  
Author(s):  
J. G. Fiedorowicz ◽  
A. C. Leon ◽  
M. B. Keller ◽  
D. A. Solomon ◽  
J. P. Rice ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Affective Disorder ◽  
Suicidal Behavior ◽  
Active Substance ◽  
Affective Disorders ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Age Of Onset ◽  
Suicide Risk Factors

BackgroundSuicide is a leading cause of death and has been strongly associated with affective disorders. The influence of affective disorder polarity on subsequent suicide attempts or completions and any differential effect of suicide risk factors by polarity were assessed in a prospective cohort.MethodParticipants with major affective disorders in the National Institute of Mental Health (NIMH) Collaborative Depression Study (CDS) were followed prospectively for up to 25 years. A total of 909 participants meeting prospective diagnostic criteria for major depressive and bipolar disorders were followed through 4204 mood cycles. Suicidal behavior was defined as suicide attempts or completions. Mixed-effects, grouped-time survival analysis assessed risk of suicidal behavior and differential effects of risk factors for suicidal behavior by polarity. In addition to polarity, the main effects of age, gender, hopelessness, married status, prior suicide attempts and active substance abuse were modeled, with mood cycle as the unit of analysis.ResultsAfter controlling for age of onset, there were no differences in prior suicide attempts by polarity although bipolar participants had more prior severe attempts. During follow-up, 40 cycles ended in suicide and 384 cycles contained at least one suicide attempt. Age, hopelessness and active substance abuse but not polarity predicted suicidal behavior. The effects of risk factors did not differ by polarity.ConclusionsBipolarity does not independently influence risk of suicidal behavior or alter the influence of well-established suicide risk factors within affective disorders. Suicide risk assessment strategies may continue to appraise these common risk factors without regard to mood polarity.

scholarly journals Serotonin transporter gene polymorphism as a predictor of short-term risk of suicide reattempts

2018 ◽  
Vol 54 ◽  
pp. 19-26 ◽  
Author(s):  
Federico M. Daray ◽  
Ángeles R. Arena ◽  
Arnaldo R. Armesto ◽  
Demián E. Rodante ◽  
Soledad Puppo ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Serotonin Transporter ◽  
Suicidal Behavior ◽  
Suicide Attempts ◽  
Age Of Onset ◽  
Short Term ◽  
History Of ◽  
Multicenter Prospective Cohort Study ◽  
Adjusted Model

AbstractObjective:The serotonin-transporter-linked polymorphic region (5-HTTLPR) polymorphisms are associated with suicidal behavior; however, prospective studies are scarce. Herein we aim to determine if 5-HTTLPR polymorphisms predict risk of short-term suicide reattempt in a high-risk suicidal sample. We also explore possible mediators or moderators of this relationship.Methods:A multicenter prospective cohort study was designed to compare data obtained form 136 patients admitted to the emergency department for current suicidal ideation or a recent suicide attempt. Subjects were clinically evaluated, genotyped, and monitored for a new suicide attempt for 6 months.Results:At 6 months of follow up, 21% of the subjects had a new suicide attempt. The frequency of L-allele and L-carrier was higher in reattempters when compared with non-reattempters (55.8% vs. 35.4%, p = 0.01 and 76.9% vs. 54.2%, p = 0.04, respectively). Reattempters also differ from non-reattempters patients with respect to age, history of previous suicide attempts, and age of onset of suicidal behavior. The logistic regression model showed that L-carriers had an odds ratio of 2.8 (95% CI: 1.0–7.6) for reattempts when compared to SS genotype. The adjusted model indicates that this association is not mediated or moderated by impulsivity.Conclusion:The 5-HTTLPR polymorphisms predicted short-term risk of suicidal reattempt independently of age and sex. L-carriers have almost three times more risk of relapse when compared with SS carriers.

scholarly journals Suicidal ideation and suicide attempts in bipolar disorder type I: an update for the clinician

2009 ◽  
Vol 31 (3) ◽  
pp. 271-280 ◽  
Author(s):  
Lena Nabuco de Abreu ◽  
Beny Lafer ◽  
Enrique Baca-Garcia ◽  
Maria A. Oquendo
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Clinical Samples ◽  
Type I ◽  
History Of ◽  
Axis I

OBJECTIVE: This article reviews the evidence for the major risk factors associated with suicidal behavior in bipolar disorder. METHOD: Review of the literature studies on bipolar disorder, suicidal behavior and suicidal ideation. RESULTS: Bipolar disorder is strongly associated with suicide ideation and suicide attempts. In clinical samples between 14-59% of the patients have suicide ideation and 25-56% present at least one suicide attempt during lifetime. Approximately 15% to 19% of patients with bipolar disorder die from suicide. The causes of suicidal behavior are multiple and complex. Some strong predictors of suicidal behavior have emerged in the literature such as current mood state, severity of depression, anxiety, aggressiveness, hostility, hopelessness, comorbidity with others Axis I and Axis II disorders, lifetime history of mixed states, and history of physical or sexual abuse. CONCLUSION: Bipolar disorder is the psychiatric condition associated with highest lifetime risk for suicide attempts and suicide completion. Thus it is important to clinicians to understand the major risk factors for suicidal behavior in order to choose better strategies to deal with this complex behavior.

Suicides and Suicide Attempts Among Psychiatric Hospital Inpatients in Iran

2019 ◽  
Vol 15 (3) ◽  
pp. 215-222
Author(s):  
Saeed Shoja Shafti ◽  
Alireza Memarie ◽  
Masomeh Rezaie ◽  
Masomeh Hamidi
Keyword(s):  
Suicidal Behavior ◽  
Serum Lipids ◽  
Psychotic Disorders ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Density Lipoprotein ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Significant Difference

Background: Suicidal behavior is seen in the context of a variety of mental disorders. While many believe that, in general, first-episode psychosis is a particularly high-risk period for suicide, no general agreement regarding higher prevalence of suicide in first-episode psychosis is achievable. Objective: In the present study, suicides and suicide attempts among psychiatric in-patients have been evaluated to assess the general profile of suicidal behavior among native psychiatric inpatients and any relationship between serum cholesterol level and suicidal behavior. Methods: Five acute academic wards, which have been specified for admission of first episode adult psychiatric patients, and five acute non-academic wards, which have been specified for admission of recurrent episode adult psychiatric patients, were selected for the current study. All inpatients with suicidal behavior (successful suicide and attempted suicide, in total), during the last five years (2013-2018), were included in the present investigation. Also, the assessment of serum lipids, including triglyceride, cholesterol, low-density lipoprotein and high-density lipoprotein, was done , for comparing the suicidal subjects with non-suicidal ones. Results: Among 19160 psychiatric patients hospitalized in Razi psychiatric hospital during a sixtymonths period, 63 suicidal behaviors, including one successful suicide and sixty-two suicide attempts, were recorded by the safety board of hospital. The most frequent mental illness was bipolar I disorder, which was significantly more prevalent in comparison with other mental disorders (p<0.04, p<0.02, p<0.007, and p<0.003 in comparison with schizophrenia, depression, personality disorders and substance abuse, respectively). Self-mutilation, self-poisoning and hanging were the preferred methods of suicide among 61.11%, 19.44% and 19.44% of cases, respectively. In addition, no significant difference was evident between the first admission and recurrent admission inpatients, totally and separately, particularly with respect to psychotic disorders. Besides, with respect to different components of serum lipids, no specific or significant pattern was evident. Conclusion: While in the present study, the suicidal behavior was significantly more evident in bipolar disorder in comparison with other psychotic or no-psychotic disorders, no significant difference was evident between the first admission and recurrent admission of psychiatric inpatients. Moreover, no significant relationship between suicidal behavior and serum lipids was found .

TPH2 Polymorphisms and alcohol-related suicide

2011 ◽  
Vol 26 (S2) ◽  
pp. 821-821
Author(s):  
A. Videtič Paska ◽  
T. Zupanc ◽  
P. Pregelj ◽  
M. Tomori ◽  
R. Komel
Keyword(s):  
Suicidal Behavior ◽  
Tryptophan Hydroxylase ◽  
Impulsive Behavior ◽  
Nucleotide Polymorphisms ◽  
Adoption Studies ◽  
Single Nucleotide ◽  
Polymerase Chain ◽  
Genetic And Environmental Factors ◽  
Alcoholism Risk

IntroductionSubstantial evidence from family, twin, and adoption studies corroborates implication of genetic and environmental factors, as well as their interactions, on suicidal behavior and alcoholism risk. Serotonergic disfunction seems to be involved in the pathophysiology of substance abuse, and has also an important role in suicidal behavior.ObjectivesRecent studies of the tryptophan hydroxylase 2 (TPH2) showed mild or no association with suicide and alcohol-related suicide.AimsInvestigation of the role of five single nucleotide polymorphisms (SNPs), one functional (p.Arg441His), two in intron 5 (Rs1843809, Rs1386493), and two in the 5’ regulatory promoter region (Rs4131348, Rs11178997) of TPH2, in association with suicide and alcohol-related suicide on a population with one of the highest suicide rates in the world.MethodsWe performed qRT-PCR (Real-Time Polymerase Chain Reaction) genotyping analysis of SNPs and alcohol analysis on 388 suicide victims and 227 controls.ResultsThe results showed association between suicide (P(X2) = 0.043) and alcohol-related suicide (P(X2) = 0.021) for SNP Rs1843809. A tendency for association was determined also for polymorphism Rs1386493 (P(X2) = 0.055) and alcohol-related suicide. Data acquired from psychological autopsies in a subsample of suicide victims (n = 79) determined more impulsive behavior (P(X2) = 0.016) and verbal aggressive behavior (P(X2) = 0.025) in the subgroup with alcohol misuse or dependency.ConclusionsOur results suggest implication of polymorphisms in suicide and alcohol-related suicide, but further studies are needed to clarify the interplay among serotonergic system disfunction, suicide, alcohol dependence, impulsivity and the role of TPH2 enzyme.

Suicidal Behavior in German Adolescents

2015 ◽  
Vol 43 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Joana Straub ◽  
Ferdinand Keller ◽  
Nina Sproeber ◽  
Michael G. Koelch ◽  
Paul L. Plener
Keyword(s):  
Suicidal Behavior ◽  
Suicide Attempts ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Present Sample ◽  
Manic Symptoms ◽  
Symptoms Of Depression ◽  
Adolescent Sample ◽  
History Of ◽  
Sum Scores

Objective: Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date. Methods: 1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior. Results: In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores. Conclusions: Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.

Serotonergic Genes and Suicidality

Crisis ◽  
2001 ◽  
Vol 22 (2) ◽  
pp. 54-60 ◽  
Author(s):  
Lisheng Du ◽  
Gabor Faludi ◽  
Miklos Palkovits ◽  
David Bakish ◽  
Pavel D. Hrdina
Keyword(s):  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Tryptophan Hydroxylase ◽  
Association Studies ◽  
Receptor Gene ◽  
Brain Regions ◽  
Depressive Illness ◽  
Control Group ◽  
Serotonergic Activity ◽  
Completed Suicide

Summary: Several lines of evidence indicate that abnormalities in the functioning of the central serotonergic system are involved in the pathogenesis of depressive illness and suicidal behavior. Studies have shown that the number of brain and platelet serotonin transporter binding sites are reduced in patients with depression and in suicide victims, and that the density of 5-HT2A receptors is increased in brain regions of depressed in suicide victims and in platelets of depressed suicidal patients. Genes that code for proteins, such as tryptophan hydroxylase, 5-HT transporter, and 5-HT2A receptor, involved in regulating serotonergic neurotransmission, have thus been major candidate genes for association studies of suicide and suicidal behavior. Recent studies by our group and by others have shown that genetic variations in the serotonin-system-related genes might be associated with suicidal ideation and completed suicide. We have shown that the 102 C allele in 5-HT2A receptor gene was significantly associated with suicidal ideation (χ2 = 8.5, p < .005) in depressed patients. Patients with a 102 C/C genotype had a significantly higher mean HAMD item #3 score (indication of suicidal ideation) than T/C or T/T genotype patients. Our results suggest that the 102T/C polymorphism in 5-HT2A receptor gene is primarily associated with suicidal ideation in patients with major depression and not with depression itself. We also found that the 5-HT transporter gene S/L polymorphism was significantly associated with completed suicide. The frequency of the L/L genotype in depressed suicide victims was almost double of that found in control group (48.6% vs. 26.2%). The odds ratio for the L allele was 2.1 (95% CI 1.2-3.7). The association between polymorphism in serotonergic genes and suicidality supports the hypothesis that genetic factors can modulate suicide risk by influencing serotonergic activity.

Suicidal Behavior in Patients with Adjustment Disorders

Crisis ◽  
2001 ◽  
Vol 22 (3) ◽  
pp. 125-131 ◽  
Author(s):  
Ludmila Kryzhanovskaya ◽  
Randolph Canterbury
Keyword(s):  
Personality Disorder ◽  
Suicidal Behavior ◽  
Suicide Attempts ◽  
Adjustment Disorder ◽  
Adjustment Disorders ◽  
Involuntary Hospitalization ◽  
Axis Ii ◽  
The Past ◽  
Substance Abuse Disorders ◽  
Axis I

Summary: This retrospective study characterizes the suicidal behavior in 119 patients with Axis I adjustment disorders as assessed by psychiatrists at the University of Virginia Hospital. Results indicated that 72 patients (60.5%) had documented suicide attempts in the past, 96% had been suicidal during their admission to the hospital, and 50% had attempted suicide before their hospitalization. The most commonly used method of suicide attempts was overdosing. Of the sample group with suicide attempts in the past, 67% had Axis II diagnoses of borderline personality disorder and antisocial personality disorder. Adjustment disorder diagnosis in patients with the suicide attempts was associated with a high level of suicidality at admission, involuntary hospitalization and substance-abuse disorders. Axis II diagnoses in patients with adjustment disorders constituted risk factors for further suicidal behavior. Additional future prospective studies with reliability checks on diagnosis of adjustment disorders and suicidal behavior are needed.

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