Familial Aggregation of Suicide Explained by Cluster B Traits: A Three-Group Family Study of Suicide Controlling for Major Depressive Disorder

kongdi

Objective Method Results Discussion Conclusions

Objectivebackground suicide aggregates in families fivefold risk increase for suicidal behavior

among relatives extent of overlap between the liability to

suicide and psychiatric disorders remains important

factors account for the familial transmission of suicidal behavior remain unclear

a predisposition to be transmitted via

intermediate phenotypes between genes and suicidal outcomes

cluster B personality disorders and associated traits may act as intermediate phenotypes of suicidal behavior

the study address these important issues by testing independence of liability to depression and suicide

a family study of suicide by examining three proband groups:

1)probands who committed suicide in the context of major depressive disorder;

2)living depressed probands with no history of suicidal behavior;

3)psychiatrically normal community

comparison probands;

Objective the comparison of rates of recurrence of

suicidal behavior in relatives of three groups

tested the hypothesis that cluster B disorders and impulsive-aggressive behavior are intermediate phenotypes of suicide.

Method Proband Groups Participants were 718 first-degree relatives from

120 families: 296 relatives of 51 depressed probands who

committed suicide; 185 relatives of 34 nonsuicidal depressed

probands; 237 relatives of 35 community comparison

subjects. Psychopathology, suicidal behavior, and

behavioral measures were assessed via interviews.

Proband Comparability and Family Ascertainment

comparable age, sex,marital status, and income ,but the first group had lower level of university education

relatives were directly and blindly assessed and scored for demographic characteristics, axis I and II disorders, suicidal behavior, and personality traits.

Assessments SCID-I and SCID-II Mental Health Clinical Research Center Suicide History Form Brown-Goodwin History of Aggression Barratt Impulsiveness Scale Buss-Durkee Hostility Inventory Temperament and Character Inventory Novelty seeking Harm avoidance Persistence

Statistical Analyses chi-square tests odds ratios and 95% confidence intervals t tests or one-way analysis of variance Tukey’s post hoc tests

Results to current,Group 1were more likely to have

met criteria for alcohol abuse and illicit substance abuse than other two groups.

Group 1 were also more likely than Group3, but not Group2, to have met criteria for lifetime alcohol abuse and illicit substance

abuse. comorbidity with cluster B personality pathology was more common among Group1

Suicidal Behavior Among Relatives Group1 had higher levels of suicidal

behavior (10.8%) than Group2 (6.5%) anGroup3(3.4%).

Group1 and Group2 were more likely than Group3 to meet criteria for current and lifetime major depressive disorder.

Group 1 had higher novelty seeking scores

than Group2. Group 1 had lower persistence scores than

both Group2 and Group3 . Group2 had higher Buss-Durkee Hostility

Inventory and harm avoidance scores than Group3 .

Cluster B Traits as Intermediate Phenotypes of Suicide testing cluster B traits as intermediate

phenotypes of suicide showed that Group 1 had

elevated levels of cluster B traits.

Prevalence among probands. Group1 exhibiting higher levels of cluster B

traits than Group3.

Association with family predisposition to suicide

familial predisposition to suicide was associated with increased levels of cluster B traits.

cluster Btraits are familialcluster B traits demonstrated familial

aggregation and were associated with

suicide attempts among relatives.

Mediating familial predisposition. cluster B traits mediated,the relationship

between familial predisposition and suicide attempts among relatives.

Cluster B Traits and the Severity of Suicidal Behavior

Discussion Suicidal Behavior

Liability to Psychiatric Illness

Impulsivity and Aggression

Strengths and Limitations

cross-generational direct and blind assessment of relatives

cross-sectional, retrospective assessment of psychopathology and suicidal behavior limited in our ability to examine suicide

completion among relatives future investigation in larger samples is

warranted

Conclusions

Familial transmission of suicide and major depression, while partially overlapping, are distinct

Cluster Btraits and impulsive-aggressive behavior represent intermediate phenotypes

of suicide.

Teacher Philips’ suggestion This study can also been done in China. They focus on the independent factor to

explain why suicide aggregates in families.

Thank you !