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Suicide and Psychosis: Results From a Population-Based Cohort of Suicide Death (N = 4380)
Schizophrenia Bulletin ( IF 6.6 ) Pub Date : 2021-09-24 , DOI: 10.1093/schbul/sbab113
Anna R Docherty 1, 2, 3 , Amanda V Bakian 1, 2 , Emily DiBlasi 1, 2 , Andrey A Shabalin 1, 2 , Danli Chen 1, 2 , Brooks Keeshin 1, 2, 4 , Eric Monson 1, 2 , Erik D Christensen 5 , Qingqin Li 6 , Douglas Gray 1, 2, 7, 8 , Hilary Coon 1, 2
Affiliation  

Abstract
Approximately 5% of individuals with schizophrenia die from suicide. However, suicide in psychosis is still poorly characterized, partly due to a lack of adequate population-based clinical or genetic data on suicide death. The Utah Suicide Genetics Research Study (USGRS) provides a large population-based cohort of suicide deaths with medical record and genome-wide data (N = 4380). Examination of this cohort identified medical and genetic risks associated with type of suicide death and investigated the relative contributions of psychotic and affective symptoms to method of suicide. Key differences in method of suicide (common vs. atypical methods) were tested in relation to lifetime psychosis and genome-wide genetic risk for schizophrenia, major depressive disorder, and neuroticism. Consistent with previous studies, psychosis-spectrum disorders were observed to be common in suicide (15% of the cohort). Individuals with psychosis more frequently died from atypical methods, with rates of atypical suicide increasing across the schizophrenia spectrum. Genetic risk for schizophrenia was also associated with atypical suicide, regardless of clinical diagnosis, though this association weakened when filtering individuals with schizophrenia from the analysis. Follow-up examination indicated that high rates of atypical suicide observed in schizophrenia are not likely accounted for by restricted access to firearms. Overall, better accounting for the increased risk of atypical suicide methods in psychosis could lead to improved prevention strategies in a large portion of the suicide risk population.


中文翻译:

自杀和精神病:基于人群的自杀死亡队列的结果(N = 4380)

摘要
大约 5% 的精神分裂症患者死于自杀。然而,精神病自杀的特征仍然很差,部分原因是缺乏足够的基于人群的自杀死亡临床或遗传数据。犹他州自杀遗传学研究 (USGRS) 提供了大量基于人群的自杀死亡队列,其中包含医疗记录和全基因组数据 ( N= 4380)。对该队列的检查确定了与自杀死亡类型相关的医学和遗传风险,并调查了精神病和情感症状对自杀方法的相对贡献。测试了自杀方法(普通与非典型方法)的主要差异与终生精神病和精神分裂症、重度抑郁症和神经质的全基因组遗传风险的关系。与以前的研究一致,精神病谱系障碍是观察到在自杀中很常见(占队列的 15%)。患有精神病的人更常死于非典型方法,在精神分裂症谱系中非典型自杀率增加。不论临床诊断如何,精神分裂症的遗传风险也与非典型自杀相关,尽管在从分析中筛选出患有精神分裂症的个体时,这种关联减弱了。后续检查表明,在精神分裂症中观察到的高非典型自杀率不太可能是由于使用枪支受限所致。总体而言,更好地解释精神病中非典型自杀方法的风险增加可能会导致大部分自杀风险人群的预防策略得到改进。
更新日期:2021-09-24
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