Family History Of Suicidal Behavior Research Articles

Nurture versus nature: evidence of intrauterine effects on suicidal behaviour

In today's Lancet, Ellenor Mittendorfer-Rutz and colleagues report on a cohort of 713 370 individuals born in Sweden between 1973 and 1980. Their goal was to assess the effects of early fetal environment and parental factors on suicidal behaviour in adolescents and young adults: intrauterine and perinatal conditions, and two maternal variables (psychosocial factors as captured by age and parity, and socioeconomic status as reflected in education level). Multivariate analyses revealed that low birthweight (below 2500 g) or being born to a mother still in adolescence increased the risk of later suicide. For suicide attempts, low birthweight and having an adolescent mother increased risk, as did low level of maternal education and being fourth or later in birth order. The effect of these factors on suicide risk was mild and less than the risk conferred by family history of suicidal behaviour. 1 Qin P Agerbo E Mortensen PB Suicide risk in relation to family history of completed suicide and psychiatric disorders: a nested case-control study based on longitudinal registers. Lancet. 2002; 360: 1126-1130 Summary Full Text Full Text PDF PubMed Scopus (256) Google Scholar Restricted fetal growth and adverse maternal psychosocial and socioeconomic conditions as risk factors for suicidal behaviour of offspring: a cohort studyMultiparity and low maternal education predicted suicide attempt, whereas restricted fetal growth and teenage motherhood were associated with both suicide completion and attempt in offspring. Full-Text PDF

Distal risk factors for suicidal behavior in alcoholics: replications and new findings

Background: To examine distal risk factors for suicidal behavior in alcoholics. Methods: Two-hundred and eighty alcoholics were interviewed and completed the Childhood Trauma (CTQ) and Eysenck Personality Questionnaires (EPQ). Results: One-hundred and twenty-one of the two-hundred and eighty alcoholics had attempted suicide (42.9%). Significantly more of the attempters were female and had a family history of suicidal behavior. Alcoholics who had attempted were significantly younger and had significantly higher CTQ scores for emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect. Attempters were significantly more introverted and neurotic on the EPQ. Significantly more alcoholics who had attempted suicide had received antidepressant medication. Limitation: Other possible distal and proximal suicide risk factors were not examined. Conclusion: These results suggest that the suicide risk factor model may be applicable to suicidal behavior in alcoholics. Distal risk factors like childhood trauma, family history of suicide, and introversion may increase an alcoholics suicide risk when they experience a proximal or trigger factor like depression.

Characteristics of drug addicts who attempt suicide

The aim of the study was to further describe the characteristics of drug-dependent patients who attempt suicide. Thus, 449 drug-dependent patients were interviewed about whether or not they had ever attempted suicide and about their family history of suicidal behavior. Patients completed the Childhood Trauma Questionnaire and the Eysenck Personality Questionnaire, and were interviewed with the Addiction Severity Index (ASI). It was found that patients who had attempted suicide ( N=175) were significantly younger than patients who had never attempted suicide ( N=274). Significantly more of the patients who had attempted suicide were female; had a family history of suicide; and had a lifetime history of major depression, of having received antidepressant medication, and of alcoholism. Also, patients who had attempted suicide had significantly higher scores for childhood trauma, psychoticism, neuroticism and introversion, as well as higher ASI psychiatric composite scores. These results suggest that social, personality, family, developmental and psychiatric risk factors may predispose to suicidal behavior in drug-dependent individuals.

Characteristics of drug addicts who attempt suicide

The aim of the study was to further describe the characteristics of drug-dependent patients who attempt suicide. Thus, 449 drug-dependent patients were interviewed about whether or not they had ever attempted suicide and about their family history of suicidal behavior. Patients completed the Childhood Trauma Questionnaire and the Eysenck Personality Questionnaire, and were interviewed with the Addiction Severity Index (ASI). It was found that patients who had attempted suicide ( N =175) were significantly younger than patients who had never attempted suicide ( N =274). Significantly more of the patients who had attempted suicide were female; had a family history of suicide; and had a lifetime history of major depression, of having received antidepressant medication, and of alcoholism. Also, patients who had attempted suicide had significantly higher scores for childhood trauma, psychoticism, neuroticism and introversion, as well as higher ASI psychiatric composite scores. These results suggest that social, personality, family, developmental and psychiatric risk factors may predispose to suicidal behavior in drug-dependent individuals.

Researchers Sketch Complex Profile of Suicide Risk

Researchers Sketch Complex Profile of Suicide Risk

Family Factors in Youth Suicidal Behaviors

Research is reviewed on family risk factors for youth suicidal behaviors. Both fatal and nonfatal suicidal behaviors have been linked consistently to negative parent-child relationships (e.g., high conflict, low closeness), child maltreatment, residing with less than two biological parents, and family history of affective and antisocial disorders. Parental separation/divorces and family history of suicidal behavior and alcohol/substance abuse are more strongly associated with completed suicide than with other suicidal symptoms, but family systems problems (such as low cohesion and adaptability) and insecure parent-child attachments are more consistently associated with nonfatal suicidal symptoms than completed suicide. Future research will benefit from attending to the temporal sequencing of putative risk factors and suicidal symptoms and from greater use of observational methods and parental reports.

Characteristics of HIV patients who attempt suicide.

To examine the risk factors for suicidal behaviour in human immunodeficiency virus (HIV) positive patients. HIV substance dependent positive patients who had attempted suicide were compared with HIV substance dependent positive patients who had never attempted suicide for suicide risk factors. Among the 149 HIV positive patients examined almost half had attempted suicide. Significantly more HIV positive patients who had attempted suicide were female. Attempters were significantly younger than non-attempters. Significantly more of the attempters had a family history of suicidal behaviour. Attempters also reported significantly more childhood trauma, scored significantly higher for neuroticism, had experienced significantly more comorbidity with depression, and more of them had received antidepressant medication. These data suggest that both distal and proximal risk factors are involved in suicidal behaviour in HIV positive substance dependent patients.

Family history of suicidal behaviour: prevalence and significance in deliberate self-harm patients.

To investigate whether there are differences between the characteristics of deliberate self-harm (DSH) patients with and without a family history of suicidal behaviour. In 146 DSH patients, those with and without a positive family history were compared with regard to the nature and repetition of their DSH episodes, and psychological and psychiatric characteristics. Fifty-two (35.6%) patients had a family history of suicidal behaviour. DSH was more frequent in patients' mothers (17.1%) than fathers (2.7%). Patients with a family history of suicidal behaviour, especially females, had higher state anger scores. Family history of suicidal behaviour appears to be associated with greater anger. Absence of other associations suggests that family history probably has less implication for individuals who have already engaged in DSH than in contributing to its initiation. Future studies should include patients with violent or life-threatening DSH acts.

History of suicidal behaviour in the families of young suicides.

The prevalence of attempted or completed suicide was studied in the families of a consecutive sample of young suicide victims aged 15-29 years. In 17 of 42 (40%) of the men and 5 of 16 (31%) of the women suicidal behaviour was found to be present in first-degree relatives. Male suicide victims with a family history of suicidal behaviour had an earlier debut of their own suicidal behaviour, longer suicidal processes, and had made more previous suicide attempts. Families in which suicidal behaviour was displayed by the victim's parents or siblings also had more frequent early separations between parent and victim and more substance abuse. Taking into account suicide by a friend or second-degree family member, it was found that 72% of suicide victims had a history of suicidal behaviour in close relationships.

Aetiology of secondary depression in male alcoholics.

Secondary depression is common among primary alcoholics. However, its aetiology is poorly understood. Forty men with primary alcoholism, abstinent for two weeks or more, with a secondary major depressive episode were compared with forty matched never-depressed primary alcoholic controls for risk factors for depression and recent life events. In the six months before the onset of depression depressed alcoholics had experienced significantly more life events, more life events with negative impact, more dependent events caused by alcohol, and more independent events. Significantly more depressed alcoholics than controls had a family history of depression, a family history of suicidal behaviour and had themselves attempted suicide. Having recent life events, particularly events with negative impact, and a family history of depression are risk factors for secondary depression in alcoholics.

Psychosocial risk factors of child and adolescent completed suicide.

Few psychosocial risk factors for completed suicide in children and adolescents have been studied systematically. The present study was designed to examine the environmental, social, and familial characteristics of a large representative sample of child and adolescent suicides. A case-control, psychological autopsy of 120 of 170 consecutive suicides younger than 20 years and 147 community age-, sex-, and ethnically matched control participants in the greater New York, NY, area. There was a significant independent impact of the psychosocial factors on increasing suicide risk among children and adolescents, beyond that risk attributable to psychiatric illness. The most notable risks were derived from school problems, a family history of suicidal behavior, poor parent-child communication, and stressful life events. Sex, ethnicity, and age modified the relationships of a few of the psychosocial factors. Socioenvironmental circumstances add significantly to a teenager's risk of suicide. The overall effect size on increasing suicide risk of the psychosocial factors is comparable with that for diagnostic factors, highlighting the importance of considering socioenvironmental factors when assessing suicide risk.

Clinical assessment versus research methods in the assessment of suicidal behavior.

This study examined how accurately routine inpatient clinical assessments documented a history of overt suicidal behavior in inpatients with a diagnosis of major depressive episode. Secondary questions involved the exploration of possible factors influencing the quality of routine clinical documentation of suicidal behavior, such as lethality of attempts, axis II comorbidity, and presence of recent suicidal behavior. Hospital records for 50 patients, known to have a history of suicidal behavior on the basis of research ratings, were reviewed to assess reporting of the number of lifetime suicide attempts, suicidal ideation and planning behavior, most medically lethal suicide attempt, and family history of suicidal behavior. These measures of suicidal behavior were compared with a comprehensive research assessment, completed concurrently and independently. At admission clinicians failed to document a history of suicidal behavior in 12 of 50 patients identified by research assessment as depressed and as having attempted suicide. Fewer total suicide attempts were clinically reported than in research data. Documentation of suicidal behavior was least accurate in the physician discharge summary and was most accurate on hospital intake assessment, which employed a semistructured format for recording clinical information including suicidal behavior. A significant degree of past suicidal behavior is not recorded during routine clinical assessment, and the use of semistructured screening instruments may improve documentation and detection of lifetime suicidal behavior. The physician discharge summary must accurately document suicidal behavior, since it best identified a high-risk population for out-patient clinicians responsible for follow-up.

Suicidality in Affectively Disordered Adolescent Inpatients

Forty-two suicidal and 14 nonsuicidal affectively ill adolescent psychiatric inpatients were compared with respect to clinical phenomenology and measures of cognitive distortion, social skills, and familial-environmental stress. The suicidal group had an earlier onset and longer duration of affective illness and greater self-rated depression. The suicidal group also evinced greater cognitive distortion, less assertiveness, a greater likelihood of both a history and exposure to familial suicidality, and more life stressors within the 12 months prior to hospitalization. Among those suicidal patients who presented with a suicide attempt, suicidal intent was related to "double depression," comorbidity with substance abuse or conduct disorder, lack of assertiveness, family conflict, and family history of suicidal behavior. Early identification and treatment of affectively ill youth that target the above-noted domains may prevent much of the associated morbidity and mortality due to suicidality.

Prevalence of specific suicidal behaviors in a high school sample.

Of 380 high school students who completed an anonymous survey concerned with their experience with suicidal behavior, 60% reported that they had thought about killing themselves. These thoughts varied with respect to persistence and planfulness. Almost 9% reported that they had actually made at least one attempt to kill themselves and over half of the suicide attempters reported at least two attempts. Fewer than half of the attempters reached the attention of mental health professionals. The data on family history of suicidal behavior suggest that the suicidal ideators and the suicide attempters represent overlapping groups.

Family history of suicidal behavior among suicide attempters.

Efforts to predict suicide and attempted suicide are hampered by their relative rarity on the one hand and the inadequate specificity of clinical characteristics and relevant antecedent events on the other; that is, these features are found widely among the nonsuicidal as well. In an effort to further understand these phenomena, the authors studied family history of suicidal behaviors (suicide, attempted suicide, and suicide threats) in 127 patients hospitalized following a suicide attempt. Patients with personality disorders (antisocial personality disorder, alcoholism, somatization disorder, and narcotic addiction), comprising 45 per cent of the sample, frequently reported a family history of these behaviors, most notably attempted suicide. Patients with primary affective disorder reported a family history of suicidal behaviors somewhat less often. The diagnoses grouped here as personality disorders (excepting alcoholism) contribute little to the suicide rate, while primary affective disorder contributes substantially. Although further data are needed, it is suggested that a family history of suicidal behavior in primary affective disorder should alert the clinician to heightened suicide risk, while a similar history in nonalcoholics with other psychiatric diagnoses is not particularly significant.

Statistical predictions of suicide in depressives

The purpose of the present study was to determine how accurately suicide potential could be identified among patients with primary affective disorder by means of multivariate statistical procedures. Among patients with this disorder, suicide has been estimated to be about 30 times more prevalent than in the general population 1 and to be the cause of death in about 15% of patients. 2 However, many patients with depressive disorder never attempt suicide or become preoccupied with suicidal thoughts. The present study is concerned with identifying some of the factors that distinguish the suicidal from the nonsuicidal depressive. A number of studies to derive predictions of suicide potential by multivariate statistical means have appeared recently. Some that have applied vague predictor variables and met with little success have been reviewed elsewhere. 3 Others have been concerned with a diagnostically heterogeneous group of patients with a history of suicide attempts in order to determine prognostic factors associated with repeated attempts. 4,5 In contrast, the present study was concerned with a diagnostically homogeneous group that is heterogeneous with regard to suicidal behavior. These patients were classified as attemptors, contemplators, or nonsuicidals according to their responses in a structured interview, and the ability of predictor variables to identify membership in one of these groups was assessed by means of discriminant function analysis. The predictor variables were age, sex, marital status, diagnostic subtype, family history of suicidal behavior, and scaled ratings of work impairment and social isolation.