Objective:

The authors examined the extent to which the genetic and environmental etiology of suicide attempt and suicide death is shared or unique.

Methods:

The authors used Swedish national registry data for a large cohort of twins, full siblings, and half siblings (N=1,314,990) born between 1960 and 1990 and followed through 2015. They conducted twin-family modeling of suicide attempt and suicide death to estimate heritability for each outcome, along with genetic and environmental correlations between them. They further assessed the relationship between suicide attempt by young people compared with adults.

Results:

In bivariate models, suicide attempt and death were moderately heritable among both women (attempt: additive genetic variance component [A]=0.52, 95% CI=0.44, 0.56; death: A=0.45, 95% CI=0.39, 0.59) and men (attempt: A=0.41, 95% CI=0.38, 0.49; death: A=0.44, 95% CI=0.43, 0.44). The outcomes were substantially, but incompletely, genetically correlated (women: rA=0.67, 95% CI=0.55, 0.67; men: rA=0.74, 95% CI=0.63, 0.87). Environmental correlations were weaker (women: rE=0.36, 95% CI=0.29, 0.45; men: rE=0.21, 95% CI=0.19, 0.27). Heritability of suicide attempt was stronger among people ages 10–24 (A=0.55–0.62) than among those age 25 and older (A=0.36–0.38), and the genetic correlation between attempt during youth and during adulthood was stronger for women (rA=0.79, 95% CI=0.72, 0.79) than for men (rA=0.39, 95% CI=0.26, 0.47).

Conclusions:

The genetic and environmental etiologies of suicide attempt and death are partially overlapping, exhibit modest sex differences, and shift across the life course. These differences must be considered when developing prevention efforts and risk prediction algorithms. Where feasible, suicide attempt and death should be considered separately rather than collapsed, including in the context of gene identification efforts.

中文翻译：

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论自杀未遂与自杀致死的遗传和环境关系

客观的：

作者检查了自杀未遂和自杀死亡的遗传和环境病因在多大程度上是共享的或独特的。

方法：

作者使用瑞典国家登记数据对 1960 年至 1990 年间出生并一直持续到 2015 年的一大群双胞胎、全兄弟姐妹和半兄弟姐妹 (N=1,314,990) 进行研究。他们对自杀未遂和自杀死亡进行了双胞胎模型，以估计遗传力对于每个结果，以及它们之间的遗传和环境相关性。他们进一步评估了年轻人自杀未遂与成年人之间的关系。

结果：

在双变量模型中，自杀未遂和死亡在两名女性中均具有中等遗传性（尝试：加性遗传方差分量 [A]=0.52, 95% CI=0.44, 0.56；死亡：A=0.45, 95% CI=0.39, 0.59）和男性（尝试：A=0.41, 95% CI=0.38, 0.49；死亡：A=0.44, 95% CI=0.43, 0.44）。结果显着但不完全地具有遗传相关性（女性：rA=0.67, 95% CI=0.55, 0.67；男性：rA=0.74, 95% CI=0.63, 0.87）。环境相关性较弱（女性：rE=0.36, 95% CI=0.29, 0.45；男性：rE=0.21, 95% CI=0.19, 0.27）。10~24 岁人群（A=0.55~0.62）的自杀未遂遗传率高于 25 岁及以上人群（A=0.36~0.38），女性在青年期和成年期自杀未遂之间的遗传相关性更强。 rA=0.79, 95% CI=0.72, 0.79) 高于男性 (rA=0.39, 95% CI=0.26, 0.47)。

结论：

自杀未遂和死亡的遗传和环境病因部分重叠，表现出适度的性别差异，并在整个生命过程中发生变化。在开发预防工作和风险预测算法时必须考虑这些差异。在可行的情况下，应分别考虑自杀未遂和死亡而不是崩溃，包括在基因鉴定工作的背景下。