title: Familial pathways to early-onset suicide attempt: risk for suicidal behavior in offspring of mood-disordered suicide attempters.
abstract: BACKGROUND
  Although adoption, twin, and family studies have shown that suicidal behavior is familial, the risk factors for familial transmission from parent to child remain unclear.
  
  
  METHODS
  A high-risk family study was conducted comparing the offspring of 2 mood-disordered groups: suicide attempters and nonattempters. Recruited from 2 sites, probands were 81 attempters and 55 nonattempters, with 183 and 116 offspring, respectively. Offspring were assessed by investigators masked to proband status. Probands and offspring were assessed with respect to psychopathologic findings, suicide attempt history, impulsive aggression, and exposure to familial environmental stressors.
  
  
  RESULTS
  Offspring of attempters had a 6-fold increased risk of suicide attempts relative to offspring of nonattempters. Familial transmission of suicide attempt was more likely if (1) probands had a history of sexual abuse and (2) offspring were female and had a mood disorder, substance abuse disorder, increased impulsive aggression, and a history of sexual abuse.
  
  
  CONCLUSIONS
  The offspring of mood-disordered suicide attempters are at markedly increased risk for suicide attempts themselves. Familial transmission of suicidal behavior in families with mood disorders almost always requires transmission of a mood disorder and is also related to the offspring's impulsive aggression and the familial transmission of sexual abuse. Early treatment of mood disorders and targeting impulsive aggression and sexual trauma may be helpful in the prevention and treatment of suicidal behavior in families with mood disorders.
authors.affiliation: Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA. brentda@msx.upmc.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
authors.forename: Maria
authors.initials: M
authors.lastname: Oquendo
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: Laurence
authors.initials: L
authors.lastname: Greenhill
authors.forename: David
authors.initials: D
authors.lastname: Kolko
authors.forename: Barbara
authors.initials: B
authors.lastname: Stanley
authors.forename: Jamie
authors.initials: J
authors.lastname: Zelazny
authors.forename: Beth
authors.initials: B
authors.lastname: Brodsky
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Bridge
authors.forename: Steve
authors.initials: S
authors.lastname: Ellis
authors.forename: J Octavio
authors.initials: JO
authors.lastname: Salazar
authors.forename: J John
authors.initials: JJ
authors.lastname: Mann
mesh_terms: D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000523:psychology; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D016241:Child of Impaired Parents / Q000523:psychology / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology / Q000523:psychology; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D019964:Mood Disorders / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*