Researchers Find Answers To Familial-Suicide Puzzle

Yes, suicides can run in the family, as “Lynn” of Topeka, Kan., knows only too well. Her father killed himself when she was 10 years old, then her father’s father killed himself when she was 12.

Familial suicides may be triggered to a large degree by the familial transmission of mood disorders. But other factors are probably responsible as well because when past studies of familial suicide behavior took familial mood disorders into account, the risk remained.

So David Brent, M.D., of the Western Psychiatric Institute and Clinic in Pittsburgh and colleagues conducted a study to identify these other risk factors. As they reported in the September Archives of General Psychiatry, some appear to be having a parent who was sexually abused, being sexually abused oneself, being female, being white, abusing substances, and acting with impulsive aggression in the face of stressful situations.

Brent and his colleagues selected for their study 299 offspring of adults who had been hospitalized for depression in either New York City or Pittsburgh. Of the 299, 183 had a parent who had attempted suicide. The researchers determined that 17 of the offspring had tried to kill themselves. The researchers also determined that all but two had parents who also had attempted suicide. This finding confirmed what a number of other studies had already found—that suicides often run in families.

Brent and his coworkers then compared the backgrounds and psychological profiles of the 19 offspring who had attempted suicide with those of the offspring who did not to discern some of the risk factors that might have prompted the 19 to take that course themselves. They found, as expected, that a mood disorder was a big risk factor, but so were having a parent who had been sexually abused, being sexually abused oneself, being female, being white, abusing substances, and being impulsively aggressive.

Nonetheless, imitation did not seem to explain to any extent why the 19 offspring had tried to kill themselves. Brent and his colleagues found that the time difference between when these offspring attempted suicide and when their parents had tried it was highly variable. In fact, in four instances, the offspring had attempted suicide before their parents.

“These findings provide a framework for potential targets for treatment and prevention,” Brent and his team concluded in their study report.

In an interview with Psychiatric News, Brent provided additional details. “The findings first help to identify who to target: offspring between the ages of 15 and 30 with a mood disorder and/or substance abuse, problems with impulsive aggression, and a history of sexual abuse whose parents are mood-disordered suicide attempters; risk is particularly high if the parent also has a history of sexual abuse. In terms of treatment, these data, while cross-sectional, do suggest that treatment of at-risk youth should involve treatment of mood disorder, substance abuse, and problems with impulsive aggression to prevent onset or recurrence of suicidal behavior. To prevent the familial transmission of suicidal behavior, one may need to target additional risk factors in the parents—mood disorder, history of sexual trauma, and the apparent familial transmission of sexual abuse. How to do this may become more clear as we follow this high-risk cohort longitudinally.”

The study was funded by National Institute of Mental Health grants.

The study, “Familial Pathways to Early-Onset Suicide Attempt,” is posted on the Web at http://archpsyc.ama-assn.org/issues/current/rfull/yoa10184.html. ▪