Citation

Wilcox HC, Fullerton JM, Glowinski AL, Benke K, Kamali M, Hulvershorn LA, Stapp EK, Edenberg HJ, Roberts GMP, Ghaziuddin N, Fisher C, Brucksch C, Frankland A, Toma C, Shaw AD, Kastelic E, Miller L, McInnis MG, Mitchell PB, Nurnberger JI. J. Am. Acad. Child Adolesc. Psychiatry 2017; 56(12): 1073-1080.

Affiliation

Indiana University School of Medicine, Indianapolis; Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis.

Copyright

(Copyright © 2017, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2017.09.428

PMID

29173741

Abstract

OBJECTIVE: Bipolar disorder (BD) is one of the most heritable psychiatric conditions and is associated with high suicide risk. To explore the reasons for this link, this study examined the interaction between traumatic stress and BD polygenic risk score in relation to suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) in adolescent and young adult offspring and relatives of persons with BD (BD-relatives) compared with adolescent and young adult offspring of individuals without psychiatric disorders (controls).

METHOD: Data were collected from 4 sites in the United States and 1 site in Australia from 2006 through 2012. Generalized estimating equation models were used to compare rates of ideation, attempts, and NSSI between BD-relatives (n = 307) and controls (n = 166) and to determine the contribution of demographic factors, traumatic stress exposure, lifetime mood or substance (alcohol/drug) use disorders, and BD polygenic risk score.

RESULTS: After adjusting for demographic characteristics and mood and substance use disorders, BD-relatives were at increased risk for suicidal ideation and attempts but not for NSSI. Independent of BD-relative versus control status, demographic factors, or mood and substance use disorders, exposure to trauma within the past year (including bullying, sexual abuse, and domestic violence) was associated with suicide attempts (p =.014), and BD polygenic risk score was marginally associated with attempts (p = .061). Importantly, the interaction between BD polygenic risk score and traumatic event exposures was significantly associated with attempts, independent of demographics, relative versus control status, and mood and substance use disorders (p =.041).

CONCLUSION: BD-relatives are at increased risk for suicide attempts and ideation, especially if they are exposed to trauma and have evidence of increased genetic vulnerability.

Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

attempted; bipolar disorder; polygenic risk; populations at risk; suicide; traumatic stress