Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
Grant support
R01 MH121455
NIMH NIH HHS - United States
R01 MH104964
NIMH NIH HHS - United States
R01 MH123489
NIMH NIH HHS - United States
R01 MH124873
NIMH NIH HHS - United States
T32 GM007347
NIGMS NIH HHS - United States
R01 MH123451
NIMH NIH HHS - United States
T32 GM152284
NIGMS NIH HHS - United States
MRF_C0396
MRF - United Kingdom
CEP Register
R01 MH116269
NIMH NIH HHS - United States
UL1 TR002538
NCATS NIH HHS - United States
G0200243
Medical Research Council - United Kingdom
MR/L010305/1
Medical Research Council - United Kingdom
S10 OD018522
NIH HHS - United States
MR/J000914/1
Medical Research Council - United Kingdom
R01 AA027522
NIAAA NIH HHS - United States
S10 OD026880
NIH HHS - United States
R01 MH119243
NIMH NIH HHS - United States
R01 MH123619
NIMH NIH HHS - United States
PubMed
34861974
PubMed Central
PMC8851871
DOI
10.1016/j.biopsych.2021.05.029
PII: S0006-3223(21)01570-5
Knihovny.cz E-resources
- Keywords
- Genetic correlation, Genome-wide association study, Pleiotropy, Polygenicity, Suicide, Suicide attempt,
- MeSH
- Genome-Wide Association Study MeSH
- Depressive Disorder, Major * genetics MeSH
- Mental Disorders * genetics MeSH
- Polymorphism, Single Nucleotide MeSH
- Humans MeSH
- Suicide, Attempted MeSH
- Risk Factors MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Research Support, N.I.H., Extramural MeSH
BACKGROUND: Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. METHODS: We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. RESULTS: Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. CONCLUSIONS: Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.
Behavioral Health Services Kaiser Permanente Washington Seattle Washington DC
BioRealm LLC Walnut California; Oregon Research Institute Eugene Oregon
Center for Applied Genomics Children's Hospital of Philadelphia Philadelphia Pennsylvania
Center for Eating Disorders at Sheppard Pratt Baltimore Maryland
Center for Research in Environmental Epidemiology Barcelona Spain
Department of Biomedical and NeuroMotor Sciences University of Bologna Bologna Italy
Department of Clinical Psychology The Chicago School of Professional Psychology Washington DC
Department of Clinical Sciences Psychiatry Umeå University Medical Faculty Umeå Sweden
Department of Environmental Epidemiology Nofer Institute of Occupational Medicine Lódz Poland
Department of Environmental Health Harvard TH Chan School of Public Health Boston Massachusetts
Department of Genetics and Genomic Biology The Hospital for Sick Children Toronto Ontario Canada
Department of Health Care Policy Harvard Medical School Boston Massachusetts
Department of Paediatric Laboratory Medicine The Hospital for Sick Children Toronto Ontario Canada
Department of Psychiatry Amsterdam UMC Vrije Universiteit and GGZ inGeest Amsterdam Netherlands
Department of Psychiatry and Behavioral Sciences Emory University School of Medicine Atlanta Georgia
Department of Psychiatry and Behavioral Sciences Stanford University Stanford California
Department of Psychiatry and Behavioral Sciences SUNY Upstate Medical University Syracuse New York
Department of Psychiatry and Neuroscience University of Gothenburg Gothenburg Sweden
Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota
Department of Psychiatry and Psychotherapy Universitätsmedizin Berlin Berlin Germany
Department of Psychiatry and Psychotherapy University Medical Center Mainz Germany
Department of Psychiatry Biomedical Research Centre University of Granada Granada Spain
Department of Psychiatry Columbia University College of Physicians and Surgeons New York New York
Department of Psychiatry Faculty of Medicine McGill University Montreal Québec Canada
Department of Psychiatry Kobe University Graduate School of Medicine Kobe Japan
Department of Psychiatry National Taiwan University Hospital and College of Medicine Taipei Taiwan
Department of Psychiatry National Taiwan University Hospital Taipei Taiwan
Department of Psychiatry UMC Utrecht Hersencentrum Utrecht the Netherlands
Department of Psychiatry Uniformed University of the Health Sciences Bethesda Maryland
Department of Psychiatry University Hospital Bellvitge IDIBELL and CIBEROBN Barcelona Spain
Department of Psychiatry University of California San Diego La Jolla California
Department of Psychiatry University of Coimbra Coimbra Portugal
Department of Psychiatry University of Iowa Iowa City Iowa
Department of Psychiatry University of Minnesota Minneapolis Minnesota
Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina
Department of Psychiatry University of Oxford Oxford United Kingdom
Department of Psychiatry University of Utah School of Medicine Salt Lake City Utah
Department of Psychiatry Virginia Commonwealth University Richmond Virginia
Department of Psychiatry Weill Cornell Medical College New York New York
Department of Psychiatry Yokohama City University Graduate School of Medicine Yokohama Japan
Department of Psychological Medicine University of Worcester Worcester United Kingdom
Department of Psychology Florida State University Tallahassee Florida
Department of Psychology Michigan State University Lansing Michigan
Department of Surgery Faculty of Medicine University of Toronto Toronto Ontario Canada
Department of Translational Genomics University of Southern California Pasadena California
Departments of Psychiatry and Radiology Columbia University New York New York
Discipline of Psychiatry University of Adelaide Adelaide South Australia Australia
Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda Maryland
Division of Psychiatry University College London London United Kingdom
Division of Psychiatry University of Edinburgh Edinburgh United Kingdom
Duke Molecular Physiology Institute Duke University Medical Center Durham North Carolina
Eating Recovery Center Denver Colorado
Health Sciences Research Mayo Clinic Rochester Minnesota
HudsonAlpha Institute for Biotechnology Huntsville Alabama
Institute for Genetics and Molecular Medicine University of Edinburgh Edinburgh United Kingdom
Institute for Genomic Health SUNY Downstate Medical Center College of Medicine Brooklyn New York
Institute for Molecular Bioscience The University of Queensland Brisbane Queensland Australia
Institute of Health and Wellbeing University of Glasgow Glasgow United Kingdom
Institute of Psychiatry and Neuroscience of Paris INSERM U1266 Université de Paris Paris France
Institute of Psychology Psychiatry and Neuroscience King's College London London United Kingdom
Max Planck Institute of Psychiatry Munich Germany
Mental Health Department University Regional Hospital Biomedicine Institute Málaga Spain
Molecular Brain Science Centre for Addiction and Mental Health Toronto Ontario Canada
Neuroscience Janssen Research and Development LLC Titusville New Jersey
Psychiatry and Human Genetics University of Pittsburgh Pittsburgh Pennsylvania
Psychiatry Berkshire Healthcare NHS Foundation Trust Bracknell United Kingdom
Psychiatry Kaiser Permanente Northern California San Francisco California
Psychiatry North East London NHS Foundation Trust Ilford Cheshire United Kingdom
Research Institute Lindner Center of HOPE Mason Ohio
School of Psychiatry University of New South Wales Sydney New South Wales Australia
School of Psychology University of New South Wales Sydney New South Wales Australia
Social Genetic and Developmental Psychiatry Centre King's College London London United Kingdom
See more in PubMed
World Health Organization: Suicide data Available at: http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/. Accessed May 9, 2020.
Centers for Disease Control and Prevention: WISQARS™ — Webbased injury statistics query and reporting system Available at: https://www.cdc.gov/injury/wisqars/index.html. Accessed May 9, 2020.
Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, et al. (2008): Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry 192:98–105. PubMed PMC
Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X, et al. (2017): Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychol Bull 143:187–232. PubMed
Fazel S, Runeson B (2020): Suicide. N Engl J Med 382:266–274. PubMed PMC
Arsenault-Lapierre G, Kim C, Turecki G (2004): Psychiatric diagnoses in 3275 suicides: A meta-analysis. BMC Psychiatry 4:37. PubMed PMC
Cavanagh JTO, Carson AJ, Sharpe M, Lawrie SM (2003): Psychological autopsy studies of suicide: A systematic review. Psychol Med 33:395–405. PubMed
Qin P (2011): The impact of psychiatric illness on suicide: Differences by diagnosis of disorders and by sex and age of subjects. J Psychiatr Res 45:1445–1452. PubMed
Ribeiro JD, Franklin JC, Fox KR, Bentley KH, Kleiman EM, Chang BP, Nock MK (2016): Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: A meta-analysis of longitudinal studies. Psychol Med 46:225–236. PubMed PMC
Ahmedani BK, Peterson EL, Hu Y, Rossom RC, Lynch F, Lu CY, et al. (2017): Major physical health conditions and risk of suicide. Am J Prev Med 53:308–315. PubMed PMC
Khazem LR (2018): Physical disability and suicide: Recent advancements in understanding and future directions for consideration. Curr Opin Psychol 22:18–22. PubMed
Bernert RA, Nadorff MR (2015): Sleep disturbances and suicide risk. Sleep Med Clin 10:35–39. PubMed
Woznica AA, Carney CE, Kuo JR, Moss TG (2015): The insomnia and suicide link: Toward an enhanced understanding of this relationship. Sleep Med Rev 22:37–46. PubMed
Pigeon WR, Pinquart M, Conner K (2012): Meta-analysis of sleep disturbance and suicidal thoughts and behaviors. J Clin Psychiatry 73:e1160–e1167. PubMed
Bishop TM, Walsh PG, Ashrafioun L, Lavigne JE, Pigeon WR (2020): Sleep, suicide behaviors, and the protective role of sleep medicine. Sleep Med 66:264–270. PubMed
Qin P, Agerbo E, Mortensen PB (2002): Suicide risk in relation to family history of completed suicide and psychiatric disorders: A nested case-control study based on longitudinal registers. Lancet 360:1126–1130. PubMed
Chesney E, Goodwin GM, Fazel S (2014): Risks of all-cause and suicide mortality in mental disorders: A meta-review. World Psychiatry 13:153–160. PubMed PMC
Poorolajal J, Darvishi N (2016): Smoking and suicide: A meta-analysis. PLoS One 11:e0156348. PubMed PMC
Orri M, Séguin JR, Castellanos-Ryan N, Tremblay RE, Côté SM, Turecki G, Geoffroy MC (2021): A genetically informed study on the association of cannabis, alcohol, and tobacco smoking with suicide attempt. Mol Psychiatry 26:5061–5070. PubMed
Harrison R, Munafò MR, Davey Smith G, Wootton RE (2020): Examining the effect of smoking on suicidal ideation and attempts: Triangulation of epidemiological approaches. Br J Psychiatry 217:701–707. PubMed PMC
McMahon K, Hoertel N, Olfson M, Wall M, Wang S, Blanco C (2018): Childhood maltreatment and impulsivity as predictors of interpersonal violence, self-injury and suicide attempts: A national study. Psychiatry Res 269:386–393. PubMed PMC
Calati R, Ferrari C, Brittner M, Oasi O, Olié E, Carvalho AF, Courtet P (2019): Suicidal thoughts and behaviors and social isolation: A narrative review of the literature. J Affect Disord 245:653–667. PubMed
Liu RT, Miller I (2014): Life events and suicidal ideation and behavior: A systematic review. Clin Psychol Rev 34:181–192. PubMed
Voracek M, Loibl LM (2007): Genetics of suicide: A systematic review of twin studies. Wien Klin Wochenschr 119:463–475. PubMed
Brent DA, Melhem N (2008): Familial transmission of suicidal behavior. Psychiatr Clin North Am 31:157–177. PubMed PMC
Fu Q, Heath AC, Bucholz KK, Nelson EC, Glowinski AL, Goldberg J, et al. (2002): A twin study of genetic and environmental influences on suicidality in men. Psychol Med 32:11–24. PubMed
Erlangsen A, Appadurai V, Wang Y, Turecki G, Mors O, Werge T, et al. (2020): Genetics of suicide attempts in individuals with and without mental disorders: A population-based genome-wide association study. Mol Psychiatry 25:2410–2421. PubMed PMC
Ruderfer DM, Walsh CG, Aguirre MW, Tanigawa Y, Ribeiro JD, Franklin JC, Rivas MA (2020): Significant shared heritability underlies suicide attempt and clinically predicted probability of attempting suicide. Mol Psychiatry 25:2422–2430. PubMed PMC
Strawbridge RJ, Ward J, Ferguson A, Graham N, Shaw RJ, Cullen B, et al. (2019): Identification of novel genome-wide associations for suicidality in UK Biobank, genetic correlation with psychiatric disorders and polygenic association with completed suicide. EBioMedicine 41:517–525. PubMed PMC
Docherty AR, Shabalin AA, DiBlasi E, Monson E, Mullins N, Adkins DE, et al. (2020): Genome-wide association study of suicide death and polygenic prediction of clinical antecedents. Am J Psychiatry 177:917–927. PubMed PMC
Mullins N, Bigdeli TB, Børglum AD, Coleman JRI, Demontis D, Mehta D, et al. (2019): GWAS of suicide attempt in psychiatric disorders and association with major depression polygenic risk scores. Am J Psychiatry 176:651–660. PubMed PMC
Kessler RC, Bromet EJ (2013): The epidemiology of depression across cultures. Annu Rev Public Health 34:119–138. PubMed PMC
Posner K, Oquendo MA, Gould M, Stanley B, Davies M (2007): Columbia Classification Algorithm of Suicide Assessment (C-CASA): Classification of suicidal events in the FDA’s pediatric suicidal risk analysis of antidepressants. Am J Psychiatry 164:1035–1043. PubMed PMC
Bulik-Sullivan BK, Loh PR, Finucane HK, Ripke S, Yang J, Schizophrenia Working Group of the Psychiatric Genomics Consortium, et al. (2015): LD Score regression distinguishes confounding from polygenicity in genome-wide association studies. Nat Genet 47:291–295. PubMed PMC
Willer CJ, Li Y, Abecasis GR (2010): METAL: Fast and efficient meta-analysis of genomewide association scans. Bioinformatics 26:2190–2191. PubMed PMC
Lam M, Awasthi S, Watson HJ, Goldstein J, Panagiotaropoulou G, Trubetskoy V, et al. (2020): RICOPILI: Rapid imputation for COnsortias PIpeLIne. Bioinformatics 36:930–933. PubMed PMC
McCarthy S, Das S, Kretzschmar W, Delaneau O, Wood AR, Teumer A, et al. (2016): A reference panel of 64,976 haplotypes for genotype imputation. Nat Genet 48:1279–1283. PubMed PMC
Zhu Z, Zheng Z, Zhang F, Wu Y, Trzaskowski M, Maier R, et al. (2018): Causal associations between risk factors and common diseases inferred from GWAS summary data. Nat Commun 9:224. PubMed PMC
Yang J, Lee SH, Goddard ME, Visscher PM (2011): GCTA: A tool for genome-wide complex trait analysis. Am J Hum Genet 88:76–82. PubMed PMC
Bachmann S (2018): Epidemiology of suicide and the psychiatric perspective. Int J Environ Res Public Health 15:1425. PubMed PMC
Wray NR, Ripke S, Mattheisen M, Trzaskowski M, Byrne EM, Abdellaoui A, et al. (2018): Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression. Nat Genet 50:668–681. PubMed PMC
1000 Genomes Project Consortium, Auton A, Brooks LD, Durbin RM, Garrison EP, Kang HM, et al. (2015): A global reference for human genetic variation. Nature 526:68–74. PubMed PMC
Stahl EA, Breen G, Forstner AJ, McQuillin A, Ripke S, Trubetskoy V, et al. (2019): Genome-wide association study identifies 30 loci associated with bipolar disorder. Nat Genet 51:793–803. PubMed PMC
Pardiñas AF, Holmans P, Pocklington AJ, Escott-Price V, Ripke S, Carrera N, et al. (2018): Common schizophrenia alleles are enriched in mutation-intolerant genes and in regions under strong background selection. Nat Genet 50:381–389. PubMed PMC
Hübel C, Gaspar HA, Coleman JRI, Finucane H, Purves KL, Hanscombe KB, et al. (2019): Genomics of body fat percentage may contribute to sex bias in anorexia nervosa. Am J Med Genet B Neuropsychiatr Genet 180:428–438. PubMed PMC
Zheng J, Mesut Erzurumluoglu A, Elsworth BL, Kemp JP, Howe L, Haycock PC, et al. (2017): LD Hub: A centralized database and web interface to perform LD score regression that maximizes the potential of summary level GWAS data for SNP heritability and genetic correlation analysis. Bioinformatics 33:272–279. PubMed PMC
Ge T, Chen C-Y, Ni Y, Feng Y-CA, Smoller JW (2019): Polygenic prediction via Bayesian regression and continuous shrinkage priors. Nat Commun 10:1776. PubMed PMC
Chang CC, Chow CC, Tellier LC, Vattikuti S, Purcell SM, Lee JJ (2015): Second-generation PLINK: Rising to the challenge of larger and richer datasets. Gigascience 4:7. PubMed PMC
Mountjoy E, Schmidt EM, Carmona M, Schwartzentruber J, Peat G, Miranda A, et al. (2021): Open Targets Genetics: An open approach to systematically prioritize causal variants and genes at all published human GWAS trait-associated loci. Nature Genetics 53:1527–1533. PubMed PMC
Wootton RE, Richmond RC, Stuijfzand BG, Lawn RB, Sallis HM, Taylor GMJ, et al. (2020): Evidence for causal effects of lifetime smoking on risk for depression and schizophrenia: A Mendelian randomisation study. Psychol Med 50:2435–2443. PubMed PMC
Karlsson Linnér R, Biroli P, Kong E, Meddens SFW, Wedow R, Fontana MA, et al. (2019): Genome-wide association analyses of risk tolerance and risky behaviors in over 1 million individuals identify hundreds of loci and shared genetic influences. Nat Genet 51:245–257. PubMed PMC
Campos AI, Verweij KJH, Statham DJ, Madden PAF, Maciejewski DF, Davis KAS, et al. (2020): Genetic aetiology of self-harm ideation and behaviour. Sci Rep 10:9713. PubMed PMC
de Leeuw CA, Mooij JM, Heskes T, Posthuma D (2015): MAGMA: Generalized gene-set analysis of GWAS data. PLoS Comput Biol 11: e1004219. PubMed PMC
GTEx Consortium, Laboratory, Data Analysis &Coordinating Center (LDACC)—Analysis Working Group, Statistical Methods groups—Analysis Working Group, Enhancing GTEx (eGTEx) groups, NIH Common Fund, NIH/NCI, et al. (2017): Genetic effects on gene expression across human tissues [published correction appears in Nature 2018; 553:530]. Nature 550:204–213. PubMed PMC
Min JL, Hemani G, Hannon E, Dekkers KF, Castillo-Fernandez J, Luijk R, et al. (2021): Genomic and phenomic insights from an atlas of genetic effects on DNA methylation. Nature Genetics 53:1311–1321. PubMed PMC
Jansen PR, Watanabe K, Stringer S, Skene N, Bryois J, Hammerschlag AR, et al. (2019): Genome-wide analysis of insomnia in 1,331,010 individuals identifies new risk loci and functional pathways. Nat Genet 51:394–403. PubMed
Bergen SE, O’Dushlaine CT, Ripke S, Lee PH, Ruderfer DM, Akterin S, et al. (2012): Genome-wide association study in a Swedish population yields support for greater CNV and MHC involvement in schizophrenia compared with bipolar disorder. Mol Psychiatry 17:880–886. PubMed PMC
Brainstorm Consortium, Anttila V, Bulik-Sullivan B, Finucane HK, Walters RK, Bras J, et al. (2018): Analysis of shared heritability in common disorders of the brain. Science 360:eaap8757. PubMed PMC
Cross-Disorder Group of the Psychiatric Genomics Consortium (2019): Genomic relationships, novel loci, and pleiotropic mechanisms across eight psychiatric disorders. Cell 179:1469–1482.e11. PubMed PMC
Agerbo E, Nordentoft M, Mortensen PB (2002): Familial, psychiatric, and socioeconomic risk factors for suicide in young people: Nested case-control study. BMJ 325:74. PubMed PMC
Qin P, Agerbo E, Mortensen PB (2003): Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: A national register–based study of all suicides in Denmark, 1981–1997. Am J Psychiatry 160:765–772. PubMed
Lorant V, de Gelder R, Kapadia D, Borrell C, Kalediene R, Kovács K, et al. (2018): Socioeconomic inequalities in suicide in Europe: The widening gap. Br J Psychiatry 212:356–361. PubMed
Kaplan ML, Asnis GM, Sanderson WC, Keswani L, De Lecuona JM, Joseph S (1994): Suicide assessment: Clinical interview vs. self-report. J Clin Psychol 50:294–298. PubMed