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Martínez-Levy GA, Cruz-Fuentes CS, Sanabrais-Jiménez MA. Genomics of Suicidal Behaviors: What Can We Learn from Polygenic Scores? Psychiatr Clin North Am 2025; 48:417-427. [PMID: 40348426 DOI: 10.1016/j.psc.2025.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2025]
Abstract
Substantial evidence supports the role of genetic factors in suicide behaviors (SBs). The most recent and powered genome-wide association studies identified significant loci for suicide, suicide attempts, and suicide ideation. Nonetheless, more research is needed to fully understand its impact. A novel approach considering the genetic complexity of SBs is polygenic scores that, in conjunction with individual and environmental factors, may have promising results to inform suicide risk stratification. Communicating this information to patients and the open population may have ethical implications that need to be considered to avoid iatrogenic effects.
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Affiliation(s)
- Gabriela Ariadna Martínez-Levy
- Departmento de Genética, Subdirección investigaciones clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México.
| | - Carlos Sabás Cruz-Fuentes
- Departmento de Genética, Subdirección investigaciones clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Marco Antonio Sanabrais-Jiménez
- Departmento de Farmacogenética, Subdirección investigaciones clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
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2
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Yotova AY, Li LL, O'Leary A, Tegeder I, Reif A, Courtney MJ, Slattery DA, Freudenberg F. Synaptic proteome perturbations after maternal immune activation: Identification of embryonic and adult hippocampal changes. Brain Behav Immun 2024; 121:351-364. [PMID: 39089536 DOI: 10.1016/j.bbi.2024.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 07/10/2024] [Accepted: 07/28/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Maternal immune activation (MIA) triggers neurobiological changes in offspring, potentially reshaping the molecular synaptic landscape, with the hippocampus being particularly vulnerable. However, critical details regarding developmental timing of these changes and whether they differ between males and females remain unclear. METHODS We induced MIA in C57BL/6J mice on gestational day nine using the viral mimetic poly(I:C) and performed mass spectrometry-based proteomic analyses on hippocampal synaptoneurosomes of embryonic (E18) and adult (20 ± 1 weeks) MIA offspring. RESULTS In the embryonic synaptoneurosomes, MIA led to lipid, polysaccharide, and glycoprotein metabolism pathway disruptions. In the adult synaptic proteome, we observed a dynamic shift toward transmembrane trafficking, intracellular signalling cascades, including cell death and growth, and cytoskeletal organisation. In adults, many associated pathways overlapped between males and females. However, we found distinct sex-specific enrichment of dopaminergic and glutamatergic pathways. We identified 50 proteins altered by MIA in both embryonic and adult samples (28 with the same directionality), mainly involved in presynaptic structure and synaptic vesicle function. We probed human phenome-wide association study data in the cognitive and psychiatric domains, and 49 of the 50 genes encoding these proteins were significantly associated with the investigated phenotypes. CONCLUSIONS Our data emphasise the dynamic effects of viral-like MIA on developing and mature hippocampi and provide novel targets for study following prenatal immune challenges. The 22 proteins that changed directionality from the embryonic to adult hippocampus, suggestive of compensatory over-adaptions, are particularly attractive for future investigations.
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Affiliation(s)
- Anna Y Yotova
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany; Goethe University Frankfurt, Faculty of Biological Sciences, Institute of Cell Biology and Neuroscience, Frankfurt, Germany
| | - Li-Li Li
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, 20520 Turku, Finland; Turku Brain and Mind Center, University of Turku and Åbo Akademi University, 20014 Turku, Finland
| | - Aet O'Leary
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany; Department of Neuropsychopharmacology, Institute of Chemistry, University of Tartu, Tartu, Estonia
| | - Irmgard Tegeder
- Goethe University Frankfurt, Faculty of Medicine, Institute of Clinical Pharmacology, Frankfurt, Germany
| | - Andreas Reif
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Michael J Courtney
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, 20520 Turku, Finland; Turku Brain and Mind Center, University of Turku and Åbo Akademi University, 20014 Turku, Finland
| | - David A Slattery
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Florian Freudenberg
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany; Goethe University Frankfurt, Faculty of Biological Sciences, Institute of Cell Biology and Neuroscience, Frankfurt, Germany.
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Cabrera-Mendoza B, Aydin N, Fries GR, Docherty AR, Walss-Bass C, Polimanti R. Estimating the direct effects of the genetic liabilities to bipolar disorder, schizophrenia, and behavioral traits on suicide attempt using a multivariable Mendelian randomization approach. Neuropsychopharmacology 2024; 49:1383-1391. [PMID: 38396255 PMCID: PMC11250798 DOI: 10.1038/s41386-024-01833-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/25/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
Bipolar disorder (BD) and schizophrenia (SZ) are associated with higher odds of suicide attempt (SA). In this study, we aimed to explore the effect of BD and SZ genetic liabilities on SA, also considering the contribution of behavioral traits, socioeconomic factors, and substance use disorders. Leveraging large-scale genome-wide association data from the Psychiatric Genomics Consortium (PGC) and the UK Biobank (UKB), we conducted a two-sample Mendelian randomization (MR) analysis to evaluate the putative causal effect of BD (41,917 cases, 371,549 controls) and SZ (53,386 cases, 77,258 controls) on SA (26,590 cases, 492,022 controls). Then, we assessed the putative causal effect of BD and SZ on behavioral traits, socioeconomic factors, and substance use disorders. Considering the associations identified, we evaluated the direct causal effect of behavioral traits, socioeconomic factors, and substance use disorders on SA using a multivariable MR approach. The genetic liabilities to BD and SZ were associated with higher odds of SA (BD odds ratio (OR) = 1.24, p = 3.88 × 10-12; SZ OR = 1.09, p = 2.44 × 10-20). However, while the effect of mental distress (OR = 1.17, p = 1.02 × 10-4) and risk-taking (OR = 1.52, p = 0.028) on SA was independent of SZ genetic liability, the BD-SA relationship appeared to account for the effect of these risk factors. Similarly, the association with loneliness on SA was null after accounting for the effect of SZ genetic liability. These findings highlight the complex interplay between genetic risk of psychiatric disorders and behavioral traits in the context of SA, suggesting the need for a comprehensive mental health assessment for high-risk individuals.
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Affiliation(s)
- Brenda Cabrera-Mendoza
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, 06516, USA.
- VA CT Healthcare System, West Haven, CT, 06516, USA.
| | - Necla Aydin
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, 06516, USA
- Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gabriel R Fries
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), 77054, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 77054, Houston, TX, USA
| | - Anna R Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Mental Health Institute, Salt Lake City, UT, USA
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Consuelo Walss-Bass
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), 77054, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 77054, Houston, TX, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, 06516, USA
- VA CT Healthcare System, West Haven, CT, 06516, USA
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Monson ET, Colbert SMC, Andreassen OA, Ayinde OO, Bejan CA, Ceja Z, Coon H, DiBlasi E, Izotova A, Kaufman EA, Koromina M, Myung W, Nurnberger JI, Serretti A, Smoller JW, Stein MB, Zai CC, Aslan M, Barr PB, Bigdeli TB, Harvey PD, Kimbrel NA, Patel PR, Ruderfer D, Docherty AR, Mullins N, Mann JJ. Defining Suicidal Thought and Behavior Phenotypes for Genetic Studies. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.27.24311110. [PMID: 39132474 PMCID: PMC11312669 DOI: 10.1101/2024.07.27.24311110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Background Standardized definitions of suicidality phenotypes, including suicidal ideation (SI), attempt (SA), and death (SD) are a critical step towards improving understanding and comparison of results in suicide research. The complexity of suicidality contributes to heterogeneity in phenotype definitions, impeding evaluation of clinical and genetic risk factors across studies and efforts to combine samples within consortia. Here, we present expert and data-supported recommendations for defining suicidality and control phenotypes to facilitate merging current/legacy samples with definition variability and aid future sample creation. Methods A subgroup of clinician researchers and experts from the Suicide Workgroup of the Psychiatric Genomics Consortium (PGC) reviewed existing PGC definitions for SI, SA, SD, and control groups and generated preliminary consensus guidelines for instrument-derived and international classification of disease (ICD) data. ICD lists were validated in two independent datasets (N = 9,151 and 12,394). Results Recommendations are provided for evaluated instruments for SA and SI, emphasizing selection of lifetime measures phenotype-specific wording. Recommendations are also provided for defining SI and SD from ICD data. As the SA ICD definition is complex, SA code list recommendations were validated against instrument results with sensitivity (range = 15.4% to 80.6%), specificity (range = 67.6% to 97.4%), and positive predictive values (range = 0.59-0.93) reported. Conclusions Best-practice guidelines are presented for the use of existing information to define SI/SA/SD in consortia research. These proposed definitions are expected to facilitate more homogeneous data aggregation for genetic and multisite studies. Future research should involve refinement, improved generalizability, and validation in diverse populations.
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Affiliation(s)
- Eric T. Monson
- Department of Psychiatry, University of Utah Spencer Fox Eccles School of Medicine
- Huntsman Mental Health Institute
| | - Sarah M. C. Colbert
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai
| | - Ole A. Andreassen
- Division of Mental Health and Addiction, Oslo University Hospital
- NORMENT Centre, University of Oslo
| | | | - Cosmin A. Bejan
- Department of Biomedical Informatics, Vanderbilt University Medical Center
| | - Zuriel Ceja
- Mental Health and Neuroscience Program, QIMR Berghofer Medical Research Institute
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland
| | - Hilary Coon
- Department of Psychiatry, University of Utah Spencer Fox Eccles School of Medicine
- Huntsman Mental Health Institute
| | - Emily DiBlasi
- Department of Psychiatry, University of Utah Spencer Fox Eccles School of Medicine
- Huntsman Mental Health Institute
| | - Anastasia Izotova
- Nic Waals Institute, Lovisenberg Diaconal Hospital
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health
- Department of Psychology, University of Oslo
| | - Erin A. Kaufman
- Department of Psychiatry, University of Utah Spencer Fox Eccles School of Medicine
- Huntsman Mental Health Institute
| | - Maria Koromina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital
- Department of Psychiatry, Seoul National University College of Medicine
| | - John I. Nurnberger
- Department of Psychiatry, Indiana University School of Medicine
- Department of Medical & Molecular Genetics, Indiana University
| | | | - Jordan W. Smoller
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital
- Stanley Center for Psychiatric Research, Broad Institute
- Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Massachusetts General Hospital
| | - Murray B. Stein
- Department of Psychiatry and School of Public Health, University of California San Diego
| | - Clement C. Zai
- Stanley Center for Psychiatric Research, Broad Institute
- Department of Psychiatry, University of Toronto
- Institute of Medical Science, University of Toronto
- Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health
- Laboratory Medicine and Pathobiology, University of Toronto
| | | | - Mihaela Aslan
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System
- Department of Internal Medicine, Yale University School of Medicine
| | - Peter B. Barr
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University
- VA New York Harbor Healthcare System
- Institute for Genomics in Health, SUNY Downstate Health Sciences University
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University
| | - Tim B. Bigdeli
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University
- VA New York Harbor Healthcare System
- Institute for Genomics in Health, SUNY Downstate Health Sciences University
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University
| | - Philip D. Harvey
- Bruce W. Carter Miami Veterans Affairs (VA) Medical Center
- University of Miami School of Medicine
| | - Nathan A. Kimbrel
- Durham VA Health Care System
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation
- VISN 6 Mid-Atlantic Mental Illness Research, Education, and Clinical Center
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
| | - Pujan R. Patel
- Durham VA Health Care System
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation
| | | | - Douglas Ruderfer
- Department of Biomedical Informatics, Vanderbilt University Medical Center
- Vanderbilt Genetics Institute, Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center
| | - Anna R. Docherty
- Department of Psychiatry, University of Utah Spencer Fox Eccles School of Medicine
- Huntsman Mental Health Institute
- Clinical and Translational Science Institute & the Center for Genomic Medicine, University of Utah
| | - Niamh Mullins
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai
| | - J. John Mann
- Departments of Psychiatry and Radiology, Columbia University
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Cabrera-Mendoza B, Aydin N, Fries GR, Docherty AR, Walss-Bass C, Polimanti R. Estimating the direct effects of the genetic liabilities to bipolar disorder, schizophrenia, and behavioral traits on suicide attempt using a multivariable Mendelian randomization approach. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.14.23294083. [PMID: 37645805 PMCID: PMC10462224 DOI: 10.1101/2023.08.14.23294083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Bipolar disorder (BD) and schizophrenia (SZ) are associated with higher odds of suicide attempt (SA). In this study, we aimed to explore the effect of BD and SZ genetic liabilities on SA, also considering the contribution of behavioral traits, socioeconomic factors, and substance use disorders. Leveraging large-scale genome-wide association data from the Psychiatric Genomics Consortium (PGC) and the UK Biobank (UKB), we conducted a two-sample Mendelian randomization (MR) analysis to evaluate the putative causal effect of BD (41,917 cases, 371,549 controls) and SZ (53,386 cases, 77,258 controls) on SA (26,590 cases, 492,022 controls). Then, we assessed the putative causal effect of BD and SZ on behavioral traits, socioeconomic factors, and substance use disorders. Considering the associations identified, we evaluated the direct causal effect of behavioral traits, socioeconomic factors, and substance use disorders on SA using a multivariable MR approach. The genetic liabilities to BD and SZ were associated with higher odds of SA (BD odds ratio (OR)=1.24, p=3.88×10-12; SZ OR=1.09, p=2.44×10-20). However, while the effect of mental distress (OR=1.17, p=1.02×10-4) and risk-taking (OR=1.52, p=0.028) on SA was independent of SZ genetic liability, the BD-SA relationship appeared to account for the effect of these risk factors. Similarly, the association with loneliness on SA was null after accounting for the effect of SZ genetic liability. These findings highlight the complex interplay between genetic risk of psychiatric disorders and behavioral traits in the context of SA, suggesting the need for a comprehensive mental health assessment for high-risk individuals.
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Affiliation(s)
- Brenda Cabrera-Mendoza
- Department of Psychiatry, Yale School of Medicine, West Haven, CT 06516, USA
- VA CT Healthcare System, West Haven, CT, 06516, USA
| | - Necla Aydin
- Department of Psychiatry, Yale School of Medicine, West Haven, CT 06516, USA
- Faculty of Medicine, Istanbul University, Turkey
| | - Gabriel R. Fries
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), 77054 Houston, Texas, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 77054 Houston, Texas, USA
| | - Anna R. Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Mental Health Institute, Salt Lake City, UT, USA
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Consuelo Walss-Bass
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), 77054 Houston, Texas, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 77054 Houston, Texas, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, West Haven, CT 06516, USA
- VA CT Healthcare System, West Haven, CT, 06516, USA
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