title: Is the serotonin transporter polymorphism (5-HTTLPR) a potential marker for suicidal behavior in bipolar disorder patients?
abstract: BACKGROUND
  Suicide prediction is a huge challenge for mental health workers. Structured interviews based on epidemiological and clinical factors don't show effectiveness for suicide prevention. Biological markers, such as 5-HTTLPR, could help for identification of potential suicide attempters.
  
  
  METHODS
  We evaluated 198 bipolar patients and 103 health controls, using a structured interview according to DSM-IV criteria. Genotyping, blind of clinical assessment for identification of S carriers and structured interviews were performed in order to describe clinical and epidemiological factors which could be associated with suicide behavior. Statistical analyses were calculated by the x(2) test and logistic regression model.
  
  
  RESULTS
  We found that 26.77% and 16.67% had a lifetime history of non violent suicide attempt and violent suicide attempt, respectively. The clinical factors associated with violent and non violent suicide attempt had several differences. Violent suicide attempters had an earlier illness onset and had a higher number of psychiatric comorbidities (borderline personality disorder, panic disorder and alcoholism). The frequency of S allele carriers was higher only in those patients who had made a violent suicide attempt in their lifetime (x(2)=16.969; p=0.0001). In a logistic regression model including these factors, S allele carrier (5-HTTLPR) was the only factor associated with violent suicide attempt.
  
  
  CONCLUSIONS
  Sample size and retrospective assessment of suicide behavior history are the limitations of this study.
  
  
  CONCLUSIONS
  Our study showed that serotonin polymorphism (5-HTTLPR) is strongly associated with violent suicidal behavior in BD patients. If confirmed, our results could be an important step to create a genetic tool for long-term suicide prediction.
authors.affiliation: Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. fneves.bhz@terra.com.br
authors.forename: Fernando Silva
authors.initials: FS
authors.lastname: Neves
authors.forename: Leandro Fernandes
authors.initials: LF
authors.lastname: Malloy-Diniz
authors.forename: Marco Aurélio
authors.initials: MA
authors.lastname: Romano-Silva
authors.forename: Gabriel Costa
authors.initials: GC
authors.lastname: Aguiar
authors.forename: Lorena Oliveira
authors.initials: LO
authors.lastname: de Matos
authors.forename: Humberto
authors.initials: H
authors.lastname: Correa
mesh_terms: D000328:Adult; D017668:Age of Onset; D000437:Alcoholism / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D000483:Alleles; D001714:Bipolar Disorder / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006580:Genetic Carrier Screening; D005819:Genetic Markers / Q000235:genetics*; D020022:Genetic Predisposition to Disease / Q000523:psychology; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D011110:Polymorphism, Genetic / Q000235:genetics*; D012307:Risk Factors; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D013406:Suicide, Attempted / Q000523:psychology*; D014754:Violence / Q000523:psychology
chemical_list: D005819:Genetic Markers; C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins