Published online by Cambridge University Press: 04 December 2009
Overview
This chapter will examine both genetic and family-environmental factors associated with suicide and suicidal behavior, with an emphasis on youthful suicidal behavior. Described herein is a model for the familial transmission of suicidal behavior that includes both genetic and nongenetic components. To conclude, the research and clinical implications of the extant literature on familial factors in suicide will be delineated.
There are several lines of evidence supporting the importance of familial factors in suicidal behavior. First, there is evidence that suicidal behavior aggregates in families from twin, adoption, and family studies. Second, while the majority of suicide victims and suicide attempters are psychiatrically ill, most psychiatrically ill patients neither attempt nor complete suicide. This suggests that a psychiatric diagnosis may be necessary, but not sufficient to explain the phenomenon of suicidal behavior. Individuals who make suicide attempts also have a diathesis for suicidal behavior. That diathesis may be subject to familial transmission, and the familial transmission of the diathesis may be distinct from the familial transmission of psychiatric disorders. Finally, many studies have noted the prevalence of a disordered family environment in suicide attempters and completers, suggesting a familial, if not a genetic, contribution to suicidal risk. Each of these categories of studies will be reviewed in turn.
Adoption studies
The classic adoption study on suicide was performed in Denmark by Schulsinger et al. (1979), comparing the rates of suicide among the biological and adoptive relatives in adoptees who committed suicide and in a matched living adoptee control group.
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