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Risks and familial coaggregation of death by suicide, accidental death and major psychiatric disorders in first-degree relatives of individuals who died by suicide

Published online by Cambridge University Press:  23 June 2023

Shih-Jen Tsai
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
Chih-Ming Cheng
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
Wen-Han Chang
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
Ya-Mei Bai
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
Ju-Wei Hsu
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
Kai-Lin Huang
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
Tung-Ping Su
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; and Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
Tzeng-Ji Chen
Affiliation:
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan; and Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
Mu-Hong Chen*
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
*
Correspondence: Mu-Hong Chen. Email: kremer7119@gmail.com

Abstract

Background

Evidence suggests a familial coaggregation of major psychiatric disorders, including schizophrenia, bipolar disorder, major depression (MDD), autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Those disorders are further related to suicide and accidental death. However, whether death by suicide may coaggregate with accidental death and major psychiatric disorders within families remains unclear.

Aims

To clarify the familial coaggregation of deaths by suicide with accidental death and five major psychiatric disorders.

Method

Using a database linked to the entire Taiwanese population, 68 214 first-degree relatives of individuals who died by suicide between 2003 and 2017 and 272 856 age- and gender-matched controls were assessed for the risks of death by suicide, accidental death and major psychiatric disorders.

Results

A Poisson regression model showed that the first-degree relatives of individuals who died by suicide were more likely to die by suicide (relative risk RR = 4.61, 95% CI 4.02–5.29) or accident (RR = 1.62, 95% CI 1.43–1.84) or to be diagnosed with schizophrenia (RR = 1.53, 95% CI 1.40–1.66), bipolar disorder (RR = 1.99, 95% CI 1.83–2.16), MDD (RR = 1.98, 95% CI 1.89–2.08) or ADHD (RR = 1.34, 95% CI 1.24–1.44).

Conclusions

Our findings identified a familial coaggregation of death by suicide with accidental death, schizophrenia, major affective disorders and ADHD. Further studies would be required to elucidate the pathological mechanisms underlying this coaggregation.

Type
Paper
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

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Footnotes

*

Joint first authors.

References

Zheng, Y, Molassiotis, A, Tyrovolas, S, Yip, PSF. Epidemiological changes, demographic drivers, and global years of life lost from suicide over the period 1990–2019. Suicide Life Threat Behav 2022; 52: 439–51.CrossRefGoogle ScholarPubMed
Fu, TS, Lee, CS, Gunnell, D, Lee, WC, Cheng, AT. Changing trends in the prevalence of common mental disorders in Taiwan: a 20-year repeated cross-sectional survey. Lancet 2013; 381: 235–41.CrossRefGoogle ScholarPubMed
Ballard, ED, Cui, L, Vandeleur, C, Castelao, E, Zarate, CA Jr., Preisig, M, et al. Familial aggregation and coaggregation of suicide attempts and comorbid mental disorders in adults. JAMA Psychiatry 2019; 76: 826–33.CrossRefGoogle ScholarPubMed
Mann, JJ, Bortinger, J, Oquendo, MA, Currier, D, Li, S, Brent, DA. Family history of suicidal behavior and mood disorders in probands with mood disorders. Am J Psychiatry 2005; 162: 1672–9.CrossRefGoogle ScholarPubMed
Joo, YY, Moon, SY, Wang, HH, Kim, H, Lee, EJ, Kim, JH, et al. Association of genome-wide polygenic scores for multiple psychiatric and common traits in preadolescent youths at risk of suicide. JAMA Netw Open 2022; 5(2): e2148585.CrossRefGoogle ScholarPubMed
Li, D, He, L. Further clarification of the contribution of the tryptophan hydroxylase (TPH) gene to suicidal behavior using systematic allelic and genotypic meta-analyses. Hum Genet 2006; 119: 233–40.CrossRefGoogle ScholarPubMed
Ljung, T, Chen, Q, Lichtenstein, P, Larsson, H. Common etiological factors of attention-deficit/hyperactivity disorder and suicidal behavior: a population-based study in Sweden. JAMA Psychiatry 2014; 71: 958–64.10.1001/jamapsychiatry.2014.363CrossRefGoogle ScholarPubMed
Fond, G, Pauly, V, Bege, T, Orleans, V, Braunstein, D, Leone, M, et al. Trauma-related mortality of patients with severe psychiatric disorders: population-based study from the French national hospital database. Br J Psychiatry 2020; 217: 568–74.CrossRefGoogle ScholarPubMed
Sun, D, Li, L, Zhang, X, Blanchard, TG, Fowler, DR, Li, L. Causes of sudden unexpected death in schizophrenia patients: a forensic autopsy population study. Am J Forensic Med Pathol 2019; 40: 312–7.10.1097/PAF.0000000000000512CrossRefGoogle ScholarPubMed
Dalsgaard, S, Ostergaard, SD, Leckman, JF, Mortensen, PB, Pedersen, MG. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet 2015; 385: 2190–6.CrossRefGoogle ScholarPubMed
Cheng, CM, Chang, WH, Chen, MH, Tsai, CF, Su, TP, Li, CT, et al. Co-aggregation of major psychiatric disorders in individuals with first-degree relatives with schizophrenia: a nationwide population-based study. Mol Psychiatry 2018; 23: 1756–63.CrossRefGoogle ScholarPubMed
Zou, G. A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol 2004; 159: 702–6.10.1093/aje/kwh090CrossRefGoogle ScholarPubMed
McGirr, A, Alda, M, Seguin, M, Cabot, S, Lesage, A, Turecki, G. Familial aggregation of suicide explained by cluster B traits: a three-group family study of suicide controlling for major depressive disorder. Am J Psychiatry 2009; 166: 1124–34.CrossRefGoogle ScholarPubMed
McGirr, A, Jollant, F, Turecki, G. Neurocognitive alterations in first degree relatives of suicide completers. J Affect Disord 2013; 145: 264–9.10.1016/j.jad.2012.05.062CrossRefGoogle ScholarPubMed
Hoehne, A, Richard-Devantoy, S, Ding, Y, Turecki, G, Jollant, F. First-degree relatives of suicide completers may have impaired decision-making but functional cognitive control. J Psychiatr Res 2015; 68: 192–7.CrossRefGoogle ScholarPubMed
Jones, JD, Boyd, RC, Calkins, ME, Moore, TM, Ahmed, A, Barzilay, R, et al. Association between family history of suicide attempt and neurocognitive functioning in community youth. J Child Psychol Psychiatry 2021; 62: 5865.CrossRefGoogle ScholarPubMed
Mullins, N, Bigdeli, TB, Borglum, AD, Coleman, JRI, Demontis, D, Mehta, D, et al. GWAS of suicide attempt in psychiatric disorders and association with major depression polygenic risk scores. Am J Psychiatry 2019; 176: 651–60.10.1176/appi.ajp.2019.18080957CrossRefGoogle ScholarPubMed
Koyama, E, Zai, CC, Bryushkova, L, Kennedy, JL, Beitchman, JH. Predicting risk of suicidal ideation in youth using a multigene panel for impulsive aggression. Psychiatry Res 2020; 285: 112726.10.1016/j.psychres.2019.112726CrossRefGoogle ScholarPubMed
Johnson, EC, Aliev, F, Meyers, JL, Salvatore, JE, Tillman, R, Chang, Y, et al. Associations between suicidal thoughts and behaviors and genetic liability for cognitive performance, depression, and risk-taking in a high-risk sample. Complex Psychiatry 2021; 7: 3444.CrossRefGoogle Scholar
Sokolowski, M, Wasserman, J, Wasserman, D. Polygenic associations of neurodevelopmental genes in suicide attempt. Mol Psychiatry 2016; 21: 1381–90.CrossRefGoogle ScholarPubMed
Weitoft, GR, Hjern, A, Haglund, B, Rosen, M. Mortality, severe morbidity, and injury in children living with single parents in Sweden: a population-based study. Lancet 2003; 361: 289–95.10.1016/S0140-6736(03)12324-0CrossRefGoogle ScholarPubMed
Gilman, SE, Ni, MY, Dunn, EC, Breslau, J, McLaughlin, KA, Smoller, JW, et al. Contributions of the social environment to first-onset and recurrent mania. Mol Psychiatry 2015; 20: 329–36.10.1038/mp.2014.36CrossRefGoogle ScholarPubMed
Cicchetti, D. Resilience under conditions of extreme stress: a multilevel perspective. World Psychiatry 2010; 9: 145–54.CrossRefGoogle Scholar
Orri, M, Geoffroy, MC, Turecki, G, Feng, B, Brendgen, M, Vitaro, F, et al. Contribution of genes and environment to the longitudinal association between childhood impulsive-aggression and suicidality in adolescence. J Child Psychol Psychiatry 2020; 61: 711–20.CrossRefGoogle Scholar
Snowdon, J, Choi, NG. Undercounting of suicides: where suicide data lie hidden. Glob Public Health 2020; 15: 1894–901.CrossRefGoogle ScholarPubMed
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