Traumatic stress and genetic risk of bipolar disorder found to increase suicide attempts

December 04, 2017

Washington, DC, December 4, 2017 - Genetic susceptibility to bipolar disorder can increase the risk for suicide attempt, but only among those who also have experienced traumatic stress, reports a study published in the December 2017 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).

Suicide in 2015 was the second leading cause of death among teens ages 15-19 with steep increases in suicide risk from ages 14 to 20. Bipolar disorder (BD) is one of the most heritable psychiatric conditions and is associated with high suicide risk.

"We found that genetic susceptibility to BD can increase the risk for suicide attempt, but only among those who also have experienced traumatic stress such as bullying, sexual abuse, and domestic violence," said lead author Holly Wilcox, PhD, an associate professor at the Johns Hopkins Bloomberg School of Public Health. "This work highlights the importance of severe environmental stressors in the development of suicide attempts in those at higher genetic risk for bipolar disorder."

The findings are based on data from 307 adolescent offspring/relatives of parents affected with BD (BD-relatives) as compared to 166 offspring/relatives of parents without specific psychiatric disorders (controls). Participants were recruited from five independent sites, four in the United States (Johns Hopkins University, University of Michigan, Washington University in St. Louis, and Indiana University) and one in Australia (University of New South Wales).

Blood samples were collected from all individuals, DNA was extracted from blood, and genome-wide genotyping was conducted. Genetic risk scores were derived from the sum of individual effects of many hundreds of BD-associated single nucleotide polymorphisms to elucidate the relative contributions of genes versus environment for suicidal behaviors in BD.

"This study uniquely examines suicidal and self-harm behaviors in a young cohort of individuals who are at increased risk of BD, but many of whom have not yet developed BD themselves," Dr. Wilcox said. "We found that offspring of BD-relatives report more suicidal ideation and attempts than controls. This finding was sustained after accounting for the presence of mood disorders and substance use disorders, suggesting that parental BD is a key correlate of suicidal ideation and attempts, and that genetic risk for suicidal behavior is not wholly acting through a genetic pathway for mood disorder." There were no differences between BD-relatives and controls in exposure to domestic violence, sexual abuse, being bullied, or a composite measure of any traumatic event exposure.
-end-
The research was supported by the National Institutes of Health (MH68009, MH073151, and MH068006), and by the Australian National Health and Medical Research Council program grants 1037196 and 1066177. The authors gratefully acknowledge the Heinz C. Prechter Bipolar Research Fund at the University of Michigan. Full author disclosures are listed in the article.

Notes for editors

The article is "Traumatic Stress Interacts With Bipolar Disorder Genetic Risk to Increase Risk for Suicide Attempts," by Holly C. Wilcox, Leslie Miller, Elizabeth Kastelic, Kelly Benke, Emma K. Stapp, Janice M. Fullerton, Claudio Toma, Alex D. Shaw, Anne L. Glowinski, Masoud Kamali, Leslie A. Hulvershorn, Howard J. Edenberg, John I. Nurnberger Jr., Carrie Fisher, Gloria M.P. Roberts, Andrew Frankland, Philip B. Mitchell, Neera Ghaziuddin, Melvin G. McInnis, and Christine Brucksch. It appears in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 56, issue 12 (December 2017), published by Elsevier.

Copies of this paper are available to credentialed journalists upon request; please contact Mary Billingsley at mbillingsley@aacap.org or +1 202 587 9672. Journalists wishing to interview the authors may contact Holly Wilcox, Johns Hopkins Bloomberg School of Public Health, hwilcox@jhsph.edu.

About JAACAP

Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families. http://www.jaacap.org

The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

About Elsevier

Elsevier is a global information analytics business that helps institutions and professionals progress science, advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. http://www.elsevier.com

Media contact

Mary Billingsley
JAACAP Editorial Office
202-587-9672
mbillingsley@aacap.org

Elsevier

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