Tuesday, April 2, 2019

Family Risk of Suicide Mediated by Presence of Psychiatric Disorders, Study Shows

Suicide runs in families, especially those in which family members have two or more psychiatric disorders, according to a report in JAMA Psychiatry. Individual family members with bipolar disorder are especially likely to have a history of suicide attempt.

Additionally, a family history of social anxiety, regardless of individual mental health status, appears to confer an increased risk for suicide.

“More than half of [first-degree relatives] with a history of suicide attempts had more than two lifetime conditions including mood, anxiety, and substance use disorders as compared to about 15% of those without a history of suicide attempts,” Kathleen Merikangas, Ph.D., of the Genetic Epidemiology Research Branch in the Intramural Research Program at NIMH (pictured left) told Psychiatric News.

A total of 1,119 study subjects and 5,355 of their first-degree relatives were recruited at two sites in Washington, D.C., and Lausanne, Switzerland. The study subjects included 154 with bipolar disorder, 475 with major depressive disorder, 182 with other non-mood disorders, and 308 controls. Data were collected and analyzed from October 2004 to December 2016.

The study found that a total of 90 study subjects (8.0%) and 199 relatives (3.7%) had a lifetime history of a suicide attempt. Among the relatives who had a suicide attempt, 56.8% (113 of 199) had a history of more than two disorders.

Relatives with bipolar I or II disorder, with or without a second psychiatric disorder, had a 36 percent higher risk of having a history of suicide attempt.

Merikangas and colleagues also found that a family history of social anxiety, regardless of individual mental health status, was associated with suicide attempts. This may reflect increased reactivity of people with social anxiety to stressors, especially those of a social nature such as loss or isolation, she said.

Screening for suicide attempts should be broadened to include individuals with mood and anxiety disorders and comorbid conditions rather than only those with major depressive disorder, Merikangas told Psychiatric News.

For related information, see the Psychiatric News article "Upping Our Game to Prevent Suicide."

(Image courtesy Kathleen Merikangas, Ph.D.)


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