Correlates of suicidal behaviors and genetic risk among United States veterans with schizophrenia or bipolar I disorder.

Autor: Bigdeli TB; VA New York Harbor Healthcare System, Brooklyn, NY, US. tim.bigdeli@downstate.edu.; Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, US. tim.bigdeli@downstate.edu.; Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US. tim.bigdeli@downstate.edu.; Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US. tim.bigdeli@downstate.edu., Barr PB; VA New York Harbor Healthcare System, Brooklyn, NY, US.; Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, US.; Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US.; Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US., Rajeevan N; Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA.; Yale University School of Medicine, New Haven, CT, USA., Graham DP; Michael E. DeBakey VA Medical Center, Houston, TX, USA.; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA., Li Y; Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA.; Yale University School of Medicine, New Haven, CT, USA., Meyers JL; Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, US.; Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US.; Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US., Gorman BR; Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA, USA., Peterson RE; Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, US.; Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US.; Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US., Sayward F; Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA.; Yale University School of Medicine, New Haven, CT, USA., Radhakrishnan K; National Mental Health and Substance Use Policy Laboratory, Substance Abuse and Mental Health Services Administration, Rockville, MD, USA., Natarajan S; VA New York Harbor Healthcare System, Brooklyn, NY, US., Nielsen DA; Michael E. DeBakey VA Medical Center, Houston, TX, USA.; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA., Wilkinson AV; Michael E. DeBakey VA Medical Center, Houston, TX, USA.; Department of Epidemiology, Human Genetics and Environmental Science, University of Texas Health Science Center at Houston, Houston, TX, USA., Malhotra AK; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA.; Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.; Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY, USA., Zhao H; Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA.; Yale University School of Medicine, New Haven, CT, USA., Brophy M; Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA, USA.; Boston University School of Medicine, Boston, MA, USA., Shi Y; Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA, USA., O'Leary TJ; Office of Research and Development, Veterans Health Administration, Washington, DC, USA., Gleason T; Office of Research and Development, Veterans Health Administration, Washington, DC, USA., Przygodzki R; Office of Research and Development, Veterans Health Administration, Washington, DC, USA., Pyarajan S; Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA, USA., Muralidhar S; Yale University School of Medicine, New Haven, CT, USA., Gaziano JM; Massachusetts Area Veterans Epidemiology, Research and Information Center (MAVERIC), Jamaica Plain, MA, USA.; Harvard University, Boston, MA, USA., Huang GD; Office of Research and Development, Veterans Health Administration, Washington, DC, USA., Concato J; Yale University School of Medicine, New Haven, CT, USA.; Office of Research and Development, Veterans Health Administration, Washington, DC, USA.; Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA., Siever LJ; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA., DeLisi LE; Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, USA., Kimbrel NA; Durham VA Health Care System, Durham, NC, USA.; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA., Beckham JC; Durham VA Health Care System, Durham, NC, USA.; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA., Swann AC; Michael E. DeBakey VA Medical Center, Houston, TX, USA.; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA., Kosten TR; Michael E. DeBakey VA Medical Center, Houston, TX, USA.; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA., Fanous AH; VA New York Harbor Healthcare System, Brooklyn, NY, US.; Department of Psychiatry, University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA., Aslan M; Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA.; Yale University School of Medicine, New Haven, CT, USA., Harvey PD; Bruce W. Carter Miami Veterans Affairs (VA) Medical Center, Miami, FL, USA.; University of Miami School of Medicine, Miami, FL, USA.
Jazyk: angličtina
Zdroj: Molecular psychiatry [Mol Psychiatry] 2024 Aug; Vol. 29 (8), pp. 2399-2407. Date of Electronic Publication: 2024 Mar 15.
DOI: 10.1038/s41380-024-02472-1
Abstrakt: Persons diagnosed with schizophrenia (SCZ) or bipolar I disorder (BPI) are at high risk for self-injurious behavior, suicidal ideation, and suicidal behaviors (SB). Characterizing associations between diagnosed health problems, prior pharmacological treatments, and polygenic scores (PGS) has potential to inform risk stratification. We examined self-reported SB and ideation using the Columbia Suicide Severity Rating Scale (C-SSRS) among 3,942 SCZ and 5,414 BPI patients receiving care within the Veterans Health Administration (VHA). These cross-sectional data were integrated with electronic health records (EHRs), and compared across lifetime diagnoses, treatment histories, follow-up screenings, and mortality data. PGS were constructed using available genomic data for related traits. Genome-wide association studies were performed to identify and prioritize specific loci. Only 20% of the veterans who reported SB had a corroborating ICD-9/10 EHR code. Among those without prior SB, more than 20% reported new-onset SB at follow-up. SB were associated with a range of additional clinical diagnoses, and with treatment with specific classes of psychotropic medications (e.g., antidepressants, antipsychotics, etc.). PGS for externalizing behaviors, smoking initiation, suicide attempt, and major depressive disorder were associated with SB. The GWAS for SB yielded no significant loci. Among individuals with a diagnosed mental illness, self-reported SB were strongly associated with clinical variables across several EHR domains. Analyses point to sequelae of substance-related and psychiatric comorbidities as strong correlates of prior and subsequent SB. Nonetheless, past SB was frequently not documented in health records, underscoring the value of regular screening with direct, in-person assessments, especially among high-risk individuals.
(© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
Databáze: MEDLINE
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