title: Clinical and genetic factors associated with suicide in mood disorder patients.
abstract: Suicidality is a continuum ranging from ideation to attempted and completed suicide, with a complex etiology involving both genetic heritability and environmental factors. The majority of suicide events occur in the context of psychiatric conditions, preeminently major depression and bipolar disorder. The present study investigates clinical factors associated with suicide in a sample of 553 mood disorder patients, recruited within the 'Psy Pluriel' center, Centre Européen de Psychologie Médicale, and the Department of Psychiatry of Erasme Hospital (Brussels). Furthermore, genetic association analyses examining polymorphisms within COMT, BDNF, MAPK1 and CREB1 genes were performed in a subsample of 259 bipolar patients. The presence or absence of a previous suicide attempt and of current suicide risk were assessed. A positive association with suicide attempt was reported for younger patients, females, lower educated, smokers, those with higher scores on depressive symptoms and higher functional disability and those with anxiety comorbidity and familial history of suicidality in first- and second-degree relatives. Anxiety disorder comorbidity was the stronger predictor of current suicide risk. No associations were found with polymorphisms within COMT and BDNF genes, whereas significant associations were found with variations in rs13515 (MAPK1) and rs6740584 (CREB1) polymorphisms. From a clinical perspective, our study proposes several clinical characteristics, such as increased depressive symptomatology, anxiety comorbidity, functional disability and family history of suicidality, as correlates associated with suicide. Genetic risk variants in MAPK1 and CREB1 genes might be involved in a dysregulation of inflammatory and neuroplasticity pathways and are worthy of future investigation.
authors.affiliation: Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands.
authors.forename: Niki
authors.initials: N
authors.lastname: Antypa
authors.affiliation: Laboratoire de Psychologie Medicale, Centre Europe´en de Psychologie Medicale, Universite´ Libre de Bruxelles and Psy Pluriel, Brussels, Belgium.
authors.forename: Daniel
authors.initials: D
authors.lastname: Souery
authors.affiliation: Department of Biomedical and NeuroMotor Sciences, Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, 40123, Bologna, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Tomasini
authors.affiliation: Laboratory of Biology of Neurodegenerative DisordersNeuroscience Department, IRCCS Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Albani
authors.affiliation: Laboratory of Biology of Neurodegenerative DisordersNeuroscience Department, IRCCS Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Fusco
authors.affiliation: Laboratoire de Psychologie Medicale, Centre Europe´en de Psychologie Medicale, Universite´ Libre de Bruxelles and Psy Pluriel, Brussels, Belgium.
authors.forename: Julien
authors.initials: J
authors.lastname: Mendlewicz
authors.affiliation: Department of Biomedical and NeuroMotor Sciences, Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, 40123, Bologna, Italy. alessandro.serretti@unibo.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serretti
mesh_terms: D000328:Adult; D000367:Age Factors; D050882:CREB-Binding Protein / Q000235:genetics*; D016009:Chi-Square Distribution; D005192:Family Health; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics* / Q000523:psychology; D005820:Genetic Testing; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019950:Mitogen-Activated Protein Kinase 1 / Q000235:genetics*; D019964:Mood Disorders / Q000235:genetics* / Q000523:psychology*; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D012189:Retrospective Studies; D012737:Sex Factors; D013405:Suicide
chemical_list: D050882:CREB-Binding Protein; C494363:CREBBP protein, human; C535150:MAPK1 protein, human; D019950:Mitogen-Activated Protein Kinase 1
keywords: Bipolar; Depression; Genetic association study; Mood disorder; Single nucleotide polymorphism; Suicide