Clustering suicidal phenotypes and genetic associations with brain-derived neurotrophic factor in patients with substance use disorders

AbstractSuicide attempts (SA), especially recurrent SA or serious SA, are common in substance use disorders (SUD). However, the genetic component of SA in SUD samples remains unclear. Brain-derived neurotrophic factor (BDNF) alleles and levels have been repeatedly involved in stress-related psychopathology. This investigation uses a within-cases study of BDNF and associated factors in three suicidal phenotypes (‘any’, ‘recurrent’, and ‘serious’) of outpatients seeking treatment for opiate and/or cocaine use disorder. Phenotypic characterization was ascertained using a semi-structured interview. After thorough quality control, 98 SNPs of BDNF and associated factors (the BDNF pathway) were extracted from whole-genome data, leaving 411 patients of Caucasian ancestry, who had reliable data regarding their SA history. Binary and multinomial regression with the three suicidal phenotypes were further performed to adjust for possible confounders, along with hierarchical clustering and compared to controls (N = 2504). Bayesian analyses were conducted to detect pleiotropy across the suicidal phenotypes. Among 154 (37%) ever suicide attempters, 104 (68%) reported at least one serious SA and 96 (57%) two SA or more. The median number of non-tobacco SUDs was three. The BDNF gene remained associated with lifetime SA in SNP-based (rs7934165, rs10835210) and gene-based tests within the clinical sample. rs10835210 clustered with serious SA. Bayesian analysis identified genetic correlation between ‘any’ and ‘serious’ SA regarding rs7934165. Despite limitations, ‘serious’ SA was shown to share both clinical and genetic risk factors of SA—not otherwise specified, suggesting a shared BDNF-related pathophysiology of SA in this population with multiple SUDs.

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Brain-derived neurotrophic factor in substance use disorders: A systematic review and meta-analysis

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2018.08.036 ◽

2018 ◽

Vol 193 ◽

pp. 91-103 ◽

Cited By ~ 9

Author(s):

Felipe Ornell ◽

Fernanda Hansen ◽

Felipe Barreto Schuch ◽

Fernando Pezzini Rebelatto ◽

Ana Laura Tavares ◽

...

Keyword(s):

Systematic Review ◽

Substance Use ◽

Substance Use Disorders ◽

Neurotrophic Factor ◽

Meta Analysis ◽

Brain Derived Neurotrophic Factor

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Tobacco smoking and other substance use disorders associated with recurrent suicide attempts in bipolar disorder

Journal of Affective Disorders ◽

10.1016/j.jad.2019.05.075 ◽

2019 ◽

Vol 256 ◽

pp. 348-357

Author(s):

R. Icick ◽

I. Melle ◽

B. Etain ◽

P.A. Ringen ◽

S.R. Aminoff ◽

...

Keyword(s):

Bipolar Disorder ◽

Substance Use ◽

Substance Use Disorders ◽

Tobacco Smoking ◽

Suicide Attempts

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Associations between substance use disorders and suicide or suicide attempts in people with mental illness: a Danish nation-wide, prospective, register-based study of patients diagnosed with schizophrenia, bipolar disorder, unipolar depression or personal

Addiction ◽

10.1111/add.13788 ◽

2017 ◽

Vol 112 (7) ◽

pp. 1250-1259 ◽

Cited By ~ 42

Author(s):

Marie L. D. Østergaard ◽

Merete Nordentoft ◽

Carsten Hjorthøj

Keyword(s):

Bipolar Disorder ◽

Mental Illness ◽

Substance Use ◽

Substance Use Disorders ◽

Suicide Attempts ◽

Unipolar Depression ◽

People With Mental Illness

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Gender-specific study of recurrent suicide attempts in outpatients with multiple substance use disorders

Journal of Affective Disorders ◽

10.1016/j.jad.2018.08.076 ◽

2018 ◽

Vol 241 ◽

pp. 546-553 ◽

Cited By ~ 5

Author(s):

R. Icick ◽

F. Vorspan ◽

E. Karsinti ◽

K. Ksouda ◽

J-P. Lépine ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Suicide Attempts ◽

Specific Study ◽

Multiple Substance ◽

Gender Specific

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VP190 A Review Of Best Practices In Five Mental Disorders In Youth

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462317004184 ◽

2017 ◽

Vol 33 (S1) ◽

pp. 237-237

Author(s):

Ionela Gheorghiu ◽

Alain Lesage ◽

Leila Ben Amor ◽

Patricia Conrod ◽

Marie-Claude Geoffroy ◽

...

Keyword(s):

Substance Use ◽

Mental Disorders ◽

Substance Use Disorders ◽

Attention Deficit ◽

Suicide Attempts ◽

Common Mental Disorders ◽

Service Planning ◽

Good Practices ◽

Hyperactivity Disorder ◽

Effective Interventions

INTRODUCTION:In order to support service planning of the youth program of the East of Montreal Health and Social Services Board, and potentially of the other twenty-five programs across the Quebec province, our hospital-based Health Technology Assessment (HTA) unit was asked to bring evidence of the effective interventions for five most common mental disorders in children and young populations, namely anxio-depressive disorders, attention deficit and hyperactivity disorder, oppositional and conduct disorders, substance abuse disorders, and suicide attempts.METHODS:A review of reviews was conducted for the five disorders in young populations aged 6 to 25 years. This was based exclusively on systematic reviews and meta-analysis of a minimum two randomized-controlled trials. The review was completed with examples of Quebec's good practices in youth mental health gathered from personal research experience of clinical researchers involved in the project. The project involved collaboration with three other hospital units and provincial HTA agencies.RESULTS:No review supporting screening and early detection for the five disorders was identified. Prevention, however, was better covered in the literature, and a clear distinction was made between universal, targeted and indicated interventions. In general, targeted and indicated prevention interventions were effective in the case of anxio-depressive (1) and substance use disorders, while universal prevention strategies seemed to reduce suicide attempts and suicide ideation (2). Effective treatments also exist for these mental disorders. In general, psychotherapies dominated for anxio-depressive and substance use disorders; parental skills dominated in oppositional disorders, whilst pharmacological treatment dominated in attention deficit and hyperactivity disorder (3). Evidence was limited for suicide attempts. The overview of Quebec's good practices allowed identification of interventions or practices already in use in the province.CONCLUSIONS:The review summarized effective interventions for five most common mental disorders in young populations. It also permitted to identify several research gaps, and therefore research recommendations were formulated for the province's health research agency.

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Over-the-Counter Drugs and Other Substances Used in Attempted Suicide Presented to Emergency Departments in Montreal, Canada

Crisis ◽

10.1027/0227-5910/a000545 ◽

2019 ◽

Vol 40 (3) ◽

pp. 166-175 ◽

Cited By ~ 1

Author(s):

Alexandre Mikhail ◽

Omaid Tanoli ◽

Gilles Légaré ◽

Pierre-André Dubé ◽

Youssef Habel ◽

...

Keyword(s):

Substance Use ◽

Suicide Attempt ◽

Substance Use Disorders ◽

Prescription Drugs ◽

Suicide Attempts ◽

Patient Characteristics ◽

Cross Sectional ◽

Over The Counter ◽

Otc Drugs ◽

Do So

Abstract. Background: Over-the-counter (OTC) analgesics are frequently used in suicide attempts. Accessibility, toxicity, and unsupervised acquisition of large amounts may be facilitators. Aims: To identify patient characteristics associated with OTC drug use as a suicide attempt method among adults. Method: A cross-sectional study was conducted using chart review of all individuals who presented to the emergency department (ED) of two adult general hospitals following a suicide attempt during 2009–2010 in Montreal, Canada. Results: Among the 369 suicide attempters identified, 181 used overdosing, 47% of whom used OTC drugs. In logistic regression, women and those with medical comorbidity were more likely to use overdosing, while those with substance use disorders were less likely to do so. Among those who overdosed, women were more likely to use OTC drugs, while those who were Caucasian, had children, comorbidities, diagnoses with substance use disorders, and made attempts in the Fall were less likely to do so. Substances most frequently used were: acetaminophen among OTC drugs (30%); antidepressants (37%), anxiolytics (30%), opioids (10%), and anticonvulsants (9%) among prescription drugs; and cocaine (10%) among recreational drugs. Limitations: Reasons for the suicide method choice were not available. Conclusion: OTC drugs, in particular acetaminophen, are frequently used in suicide attempts. Accessibility to these drugs may be an important contributor.

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