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Increased severity of suicidal behavior in impulsive aggressive patients exposed to familial adversities

Published online by Cambridge University Press:  26 March 2014

J. Lopez-Castroman ,
I. Jaussent ,
S. Beziat ,
S. Guillaume ,
E. Baca-Garcia ,
C. Genty ,
E. Olié  and
P. Courtet
J. Lopez-Castroman*
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France IIS-Fundacion Jimenez Diaz, Department of Psychiatry, CIBERSAM, Madrid, Spain Department of Emergency Psychiatry, CHRU Montpellier, France
I. Jaussent
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France
S. Beziat
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France
S. Guillaume
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France Department of Emergency Psychiatry, CHRU Montpellier, France
E. Baca-Garcia
Affiliation:
IIS-Fundacion Jimenez Diaz, Department of Psychiatry, CIBERSAM, Madrid, Spain Department of Psychiatry at the New York State Psychiatric Institute and Columbia University, NY, USA
C. Genty
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France Department of Emergency Psychiatry, CHRU Montpellier, France
E. Olié
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France Department of Emergency Psychiatry, CHRU Montpellier, France
P. Courtet
Affiliation:
Inserm U1061, Hôpital La Colombiere, Montpellier, France; University of Montpellier 1, France Department of Emergency Psychiatry, CHRU Montpellier, France
*
*Address for correspondence: J. Lopez-Castroman, M.D., Ph.D., Inserm U1061, Hôpital La Colombiere, Pavillon 42, 39 av. Charles Flauhault, BP 34493, 34093 Montpellier, France. (Email: [email protected])
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Abstract

Background

The mechanisms by which childhood abuse and family history of suicidal behavior (FHS) lead to an increased risk of suicidal behavior are still unknown. Impulsive aggression may play an intermediate role. We investigated whether greater scores for aggression and impulsivity might be associated with the effects of FHS and/or childhood abuse on the severity of suicidal behavior.

Method

We examined the scores of three scales measuring impulsive aggression in a sample of 696 suicide attempters. We compared the highest and lowest scores with regard to reports of childhood abuse and FHS using adjusted multinomial regression models. Genetic polymorphisms of the serotonergic system known to be associated with impulsive aggression were also analyzed.

Results

Patients with high impulsive aggressive scores showed significant differences in sociodemographic, clinical and suicidal features compared with patients with low impulsive aggressive scores. Adjusted results showed that combinations of some types of childhood abuse and FHS, particularly emotional abuse and emotional neglect, are associated with high impulsivity and hostility scores. The SS genotype of the serotonin transporter gene (5-HTTLPR) was associated with high levels of impulsivity when the subjects reported emotional abuse [odds ratio (OR) 5.55, 95% confidence interval (CI) 1.75–17.5] or physical abuse (OR 5.03, 95% CI 1.50–16.9) in their childhood.

Conclusions

Our results support the role of impulsive aggression as one of the links that may connect childhood abuse and FHS with severity of suicidal behavior.

Keywords

Childhood abusegene–environment interaction5-HTTPLPRimpulsivitysuicidal behavior
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 14 , October 2014 , pp. 3059 - 3068
Copyright
Copyright © Cambridge University Press 2014 

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