Traumatic Stress Interacts With Bipolar Disorder Genetic Risk to Increase Risk for Suicide Attempts

Holly Wilcox, Janice M. Fullerton, Anne L. Glowinski, Kelly Benke, Masoud Kamali, Leslie A. Hulvershorn, Emma K. Stapp, Howard J. Edenberg, Gloria M.P. Roberts, Neera Ghaziuddin, Carrie Fisher, Christine Brucksch, Andrew Frankland, Claudio Toma, Alex D. Shaw, Elizabeth A Kastelic, Leslie Miller, Melvin G. McInnis, Philip B. Mitchell, John I. Nurnberger

Research output: Contribution to journalArticle

Abstract

Objective Bipolar disorder (BD) is one of the most heritable psychiatric conditions and is associated with high suicide risk. To explore the reasons for this link, this study examined the interaction between traumatic stress and BD polygenic risk score in relation to suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) in adolescent and young adult offspring and relatives of persons with BD (BD-relatives) compared with adolescent and young adult offspring of individuals without psychiatric disorders (controls). Method Data were collected from 4 sites in the United States and 1 site in Australia from 2006 through 2012. Generalized estimating equation models were used to compare rates of ideation, attempts, and NSSI between BD-relatives (n = 307) and controls (n = 166) and to determine the contribution of demographic factors, traumatic stress exposure, lifetime mood or substance (alcohol/drug) use disorders, and BD polygenic risk score. Results After adjusting for demographic characteristics and mood and substance use disorders, BD-relatives were at increased risk for suicidal ideation and attempts but not for NSSI. Independent of BD-relative versus control status, demographic factors, or mood and substance use disorders, exposure to trauma within the past year (including bullying, sexual abuse, and domestic violence) was associated with suicide attempts (p =.014), and BD polygenic risk score was marginally associated with attempts (p =.061). Importantly, the interaction between BD polygenic risk score and traumatic event exposures was significantly associated with attempts, independent of demographics, relative versus control status, and mood and substance use disorders (p =.041). Conclusion BD-relatives are at increased risk for suicide attempts and ideation, especially if they are exposed to trauma and have evidence of increased genetic vulnerability.

Original languageEnglish (US)
Pages (from-to)1073-1080
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume56
Issue number12
DOIs
StatePublished - Dec 1 2017

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Bipolar Disorder
Suicide
Substance-Related Disorders
Demography
Wounds and Injuries
Suicidal Ideation
Sex Offenses
Adult Children
Psychiatry
Young Adult
Traumatic Stress Disorders
Bullying
Domestic Violence
Alcohols

Keywords

  • attempted
  • bipolar disorder
  • polygenic risk
  • populations at risk
  • suicide
  • traumatic stress

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

Traumatic Stress Interacts With Bipolar Disorder Genetic Risk to Increase Risk for Suicide Attempts. / Wilcox, Holly; Fullerton, Janice M.; Glowinski, Anne L.; Benke, Kelly; Kamali, Masoud; Hulvershorn, Leslie A.; Stapp, Emma K.; Edenberg, Howard J.; Roberts, Gloria M.P.; Ghaziuddin, Neera; Fisher, Carrie; Brucksch, Christine; Frankland, Andrew; Toma, Claudio; Shaw, Alex D.; Kastelic, Elizabeth A; Miller, Leslie; McInnis, Melvin G.; Mitchell, Philip B.; Nurnberger, John I.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 56, No. 12, 01.12.2017, p. 1073-1080.

Research output: Contribution to journalArticle

Wilcox, H, Fullerton, JM, Glowinski, AL, Benke, K, Kamali, M, Hulvershorn, LA, Stapp, EK, Edenberg, HJ, Roberts, GMP, Ghaziuddin, N, Fisher, C, Brucksch, C, Frankland, A, Toma, C, Shaw, AD, Kastelic, EA, Miller, L, McInnis, MG, Mitchell, PB & Nurnberger, JI 2017, 'Traumatic Stress Interacts With Bipolar Disorder Genetic Risk to Increase Risk for Suicide Attempts', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 56, no. 12, pp. 1073-1080. https://doi.org/10.1016/j.jaac.2017.09.428
Wilcox, Holly ; Fullerton, Janice M. ; Glowinski, Anne L. ; Benke, Kelly ; Kamali, Masoud ; Hulvershorn, Leslie A. ; Stapp, Emma K. ; Edenberg, Howard J. ; Roberts, Gloria M.P. ; Ghaziuddin, Neera ; Fisher, Carrie ; Brucksch, Christine ; Frankland, Andrew ; Toma, Claudio ; Shaw, Alex D. ; Kastelic, Elizabeth A ; Miller, Leslie ; McInnis, Melvin G. ; Mitchell, Philip B. ; Nurnberger, John I. / Traumatic Stress Interacts With Bipolar Disorder Genetic Risk to Increase Risk for Suicide Attempts. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2017 ; Vol. 56, No. 12. pp. 1073-1080.
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abstract = "Objective Bipolar disorder (BD) is one of the most heritable psychiatric conditions and is associated with high suicide risk. To explore the reasons for this link, this study examined the interaction between traumatic stress and BD polygenic risk score in relation to suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) in adolescent and young adult offspring and relatives of persons with BD (BD-relatives) compared with adolescent and young adult offspring of individuals without psychiatric disorders (controls). Method Data were collected from 4 sites in the United States and 1 site in Australia from 2006 through 2012. Generalized estimating equation models were used to compare rates of ideation, attempts, and NSSI between BD-relatives (n = 307) and controls (n = 166) and to determine the contribution of demographic factors, traumatic stress exposure, lifetime mood or substance (alcohol/drug) use disorders, and BD polygenic risk score. Results After adjusting for demographic characteristics and mood and substance use disorders, BD-relatives were at increased risk for suicidal ideation and attempts but not for NSSI. Independent of BD-relative versus control status, demographic factors, or mood and substance use disorders, exposure to trauma within the past year (including bullying, sexual abuse, and domestic violence) was associated with suicide attempts (p =.014), and BD polygenic risk score was marginally associated with attempts (p =.061). Importantly, the interaction between BD polygenic risk score and traumatic event exposures was significantly associated with attempts, independent of demographics, relative versus control status, and mood and substance use disorders (p =.041). Conclusion BD-relatives are at increased risk for suicide attempts and ideation, especially if they are exposed to trauma and have evidence of increased genetic vulnerability.",
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AU - Wilcox, Holly

AU - Fullerton, Janice M.

AU - Glowinski, Anne L.

AU - Benke, Kelly

AU - Kamali, Masoud

AU - Hulvershorn, Leslie A.

AU - Stapp, Emma K.

AU - Edenberg, Howard J.

AU - Roberts, Gloria M.P.

AU - Ghaziuddin, Neera

AU - Fisher, Carrie

AU - Brucksch, Christine

AU - Frankland, Andrew

AU - Toma, Claudio

AU - Shaw, Alex D.

AU - Kastelic, Elizabeth A

AU - Miller, Leslie

AU - McInnis, Melvin G.

AU - Mitchell, Philip B.

AU - Nurnberger, John I.

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N2 - Objective Bipolar disorder (BD) is one of the most heritable psychiatric conditions and is associated with high suicide risk. To explore the reasons for this link, this study examined the interaction between traumatic stress and BD polygenic risk score in relation to suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) in adolescent and young adult offspring and relatives of persons with BD (BD-relatives) compared with adolescent and young adult offspring of individuals without psychiatric disorders (controls). Method Data were collected from 4 sites in the United States and 1 site in Australia from 2006 through 2012. Generalized estimating equation models were used to compare rates of ideation, attempts, and NSSI between BD-relatives (n = 307) and controls (n = 166) and to determine the contribution of demographic factors, traumatic stress exposure, lifetime mood or substance (alcohol/drug) use disorders, and BD polygenic risk score. Results After adjusting for demographic characteristics and mood and substance use disorders, BD-relatives were at increased risk for suicidal ideation and attempts but not for NSSI. Independent of BD-relative versus control status, demographic factors, or mood and substance use disorders, exposure to trauma within the past year (including bullying, sexual abuse, and domestic violence) was associated with suicide attempts (p =.014), and BD polygenic risk score was marginally associated with attempts (p =.061). Importantly, the interaction between BD polygenic risk score and traumatic event exposures was significantly associated with attempts, independent of demographics, relative versus control status, and mood and substance use disorders (p =.041). Conclusion BD-relatives are at increased risk for suicide attempts and ideation, especially if they are exposed to trauma and have evidence of increased genetic vulnerability.

AB - Objective Bipolar disorder (BD) is one of the most heritable psychiatric conditions and is associated with high suicide risk. To explore the reasons for this link, this study examined the interaction between traumatic stress and BD polygenic risk score in relation to suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) in adolescent and young adult offspring and relatives of persons with BD (BD-relatives) compared with adolescent and young adult offspring of individuals without psychiatric disorders (controls). Method Data were collected from 4 sites in the United States and 1 site in Australia from 2006 through 2012. Generalized estimating equation models were used to compare rates of ideation, attempts, and NSSI between BD-relatives (n = 307) and controls (n = 166) and to determine the contribution of demographic factors, traumatic stress exposure, lifetime mood or substance (alcohol/drug) use disorders, and BD polygenic risk score. Results After adjusting for demographic characteristics and mood and substance use disorders, BD-relatives were at increased risk for suicidal ideation and attempts but not for NSSI. Independent of BD-relative versus control status, demographic factors, or mood and substance use disorders, exposure to trauma within the past year (including bullying, sexual abuse, and domestic violence) was associated with suicide attempts (p =.014), and BD polygenic risk score was marginally associated with attempts (p =.061). Importantly, the interaction between BD polygenic risk score and traumatic event exposures was significantly associated with attempts, independent of demographics, relative versus control status, and mood and substance use disorders (p =.041). Conclusion BD-relatives are at increased risk for suicide attempts and ideation, especially if they are exposed to trauma and have evidence of increased genetic vulnerability.

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