Childhood IQ and mortality during 53 years’ follow-up of Swedish men and women

Wallin, Alma Sörberg; Allebeck, Peter; Gustafsson, Jan‐Eric; Hemmingsson, Tomas

doi:10.1136/jech-2018-210675

Cited by 12 publications

(8 citation statements)

References 36 publications

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“…In the SVMR analysis, we found that CP reduces the risk for attempting suicide by almost 30%; however, after incorporating EA and income into a MVMR framework, CP was no longer associated with suicidal behavior, which supports previous observational literature finding that EA explains a substantial proportion of the association between CP and suicidal behavior 80 – 82 . CP and EA are genetically correlated 37 , and there is MR evidence supporting a bidirectional relationship between EA and CP 73 ; however, using MVMR methods and sensitivity analyses to assess for possible pleiotropy, we were able to extricate their independent effects on the risk for having attempted suicide, which is critical when considering policies aimed at preventing suicide.…”

Section: Discussionsupporting

confidence: 84%

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a bidirectional and multivariable Mendelian randomization study with more than 815,000 participants

et al. 2020

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Rates of suicidal behavior are increasing in the United States and identifying causal risk factors continues to be a public health priority. Observational literature has shown that educational attainment (EA) and cognitive performance (CP) influence suicide attempt risk; however, the causal nature of these relationships is unknown. Using summary statistics from genome-wide association studies (GWAS) of EA, CP, and suicide attempt risk with > 815,000 combined white participants of European ancestry, we performed multivariable Mendelian randomization (MR) to disentangle the effects of EA and CP on attempted suicide. In single-variable MR (SVMR), EA and CP appeared to reduce suicide attempt risk (EA odds ratio (OR) per standard deviation (SD) increase in EA (4.2 years), 0.524, 95% CI, 0.412–0.666, P = 1.07 × 10−7; CP OR per SD increase in standardized score, 0.714, 95% CI, 0.577–0.885, P = 0.002). Conversely, bidirectional analyses found no effect of a suicide attempt on EA or CP. Using various multivariable MR (MVMR) models, EA seems to be the predominant risk factor for suicide attempt risk with the independent effect (OR, 0.342, 95% CI, 0.206–0.568, P = 1.61 × 10−4), while CP had no effect (OR, 1.182, 95% CI, 0.842–1.659, P = 0.333). In additional MVMR analyses accounting simultaneously for potential behavioral and psychiatric mediators (tobacco smoking; alcohol consumption; and self-reported nerves, tension, anxiety, or depression), the effect of EA was little changed (OR, 0.541, 95% CI, 0.421–0.696, P = 3.33 × 10−6). Consistency of results across complementary MR methods accommodating different assumptions about genetic pleiotropy strengthened causal inference. Our results show that even after accounting for psychiatric disorders and behavioral mediators, EA, but not CP, may causally influence suicide attempt risk among white individuals of European ancestry, which could have important implications for health policy and programs aimed at reducing the increasing rates of suicide. Future work is necessary to examine the EA–suicide relationship populations of different ethnicities.

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Section: Discussionsupporting

confidence: 84%

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a bidirectional and multivariable Mendelian randomization study with more than 815,000 participants

et al. 2020

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“…Notably, in our single-variable MR analysis, we found that CP reduces the risk for attempting suicide by almost 30%; however, after incorporating EA and income into a MVMR framework, CP was no longer significantly associated with suicidal behavior, which supports previous observational literature finding that EA explains a substantial proportion of the association between CP and suicidal behavior [60][61][62]. CP and EA are genetically correlated [36], and there is MR evidence supporting a bi-directional relationship between EA and CP [54]; however, using multivariable MR methods and sensitivity analyses to assess for possible pleiotropy, we were able to extricate their direct effects on the risk for having attempted suicide, which is critical when considering policies aimed at preventing suicide.…”

Section: Discussionsupporting

confidence: 85%

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a multivariable Mendelian randomization study with more than 815,000 participants

Rosoff

Kaminsky

Lohoff

2019

Preprint

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Background: Rates of suicidal ideation, attempts and completions are increasing and identifying causal risk factors continues to be a public health priority. Observational literature has shown that educational attainment (EA) and cognitive performance (CP) can influence suicide attempt risk; however, due to residual confounding and reverse causation, the causal nature of these relationships is unknown. Methods: We perform a multivariable two-sample Mendelian randomization (MR) analysis to disentangle the effects of EA and CP on suicide attempt risk. We use summary statistics from recent genome-wide association studies (GWAS) of EA, CP, household income versus suicide attempt risk in individuals with and without mental disorders, with more than 815,000 combined study participants. Results: We found evidence that both EA and CP significantly reduced the risk of suicide attempt when considered separately in single variable MR (SVMR) (Model 1 EA odds ratio (OR), 0.524, 95% CI, 0.412-0.666, P = 1.07x10-7; CP OR, 0.714, 95% CI, 0.577-0.885, P = 0.002). When simultaneously analyzing EA, CA, and adjusting for household income but not comorbid mental disorders (Model 1), we found evidence that the direct effect of EA, independent of CP, on suicide attempt risk was greater than the total effect estimated by SVMR, with EA, independent of CP, significantly reducing the risk of suicide attempt by almost 66% (95% CI, 43%-79%); however, the effect of CP was no longer significant independent of EA (Model 1 EA OR, 0.342, 95% CI, 0.206-0.568, P = 1.61x10-4; CP OR, 1.182, 95% CI, 0.842-1.659, P = 0.333). Further, when accounting for comorbid mental disorders (Model 2), these results did not significantly change: we found EA significantly reduced the risk of suicide attempt by 55% (35%-68%), a lower point estimate but still within the 95% confidence interval of Model 1; the effect of CP was still not significant (Model 2 EA OR, 0.450, 95% CI, 0.314-0.644, P < 1.00x10-4; CP OR, 1.143, 95% CI, 0.803-1.627, P = 0.475). Conclusions: Our results show that even after accounting for comorbid mental disorders and adjusting for household income, EA, but not CP, is a causal risk factor in suicide attempt. These findings could have important implications for health policy and prevention programs aimed at reducing the increasing rates of suicide.

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“…On the other hand, one possible reason for the long-term association between intelligence and suicidal behavior is that intelligence is robustly associated with attained education and socioeconomic position in adulthood (Plomin and Deary, 2015). These factors have been found to explain substantial proportions of the association between intelligence in youth and suicidal behavior in adulthood (Sörberg et al ., 2013; Sörberg Wallin et al ., 2018 a ). They may be relevant to prevention at the societal level, not least because socioeconomic factors contribute considerably to suicide risk at the population level (Li et al ., 2011).…”

Section: Discussionmentioning

confidence: 99%

“…They may be relevant to prevention at the societal level, not least because socioeconomic factors contribute considerably to suicide risk at the population level (Li et al ., 2011). Of note is that this pathway might be more important for suicide prevention in men than in women; in women, low intelligence seems to be associated with suicide attempt (Sörberg Wallin et al ., 2018 b ) but not death from suicide (Andersson et al ., 2008; Calvin et al ., 2017; Sörberg Wallin et al ., 2018 a ). The fact that gender differences are observed in these relationships further supports the hypothesis that social and socioeconomic factors are involved as mediators or moderators in the associations.…”

Section: Discussionmentioning

confidence: 99%

How intelligence and emotional control are related to suicidal behavior across the life course – A register-based study with 38-year follow-up

2019

Self Cite

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BackgroundBoth low intelligence and low emotional control have previously been linked to a higher risk of suicide, but it is unknown whether the associations apply consistently over the life course.MethodsThe study was based on data on intelligence and emotional control, collected from 48 738 Swedish men conscripted in 1969–1970, at ages 18–20 years. The data were linked to national registers giving information on subsequent suicidal behavior (completed and attempted suicide) up to the age of 59 years. The associations were investigated using logistic regression and Cox proportional hazards regression models, with adjustment for childhood socioeconomic status.ResultsIntelligence and emotional control assessed in late adolescence both showed robust inverse associations with suicidal behavior over the 38-year follow-up. However, while the association between lower intelligence and higher rate of suicidal behavior remained the same throughout (~40% increased hazard per unit on a five-level scale), the association between lower emotional control and suicidal behavior was substantially stronger in early adulthood (~100% increased hazard per unit) than in late middle age (~30% increased hazard per unit).ConclusionsThe study adds to previous research by showing that the association between poor emotional control and subsequent suicide risk in men becomes weaker over the life course, while the association between low intelligence and suicide risk seems to be constant. The particularly high suicide risk of young men with poor emotional control may motivate targeted prevention efforts.

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Childhood IQ and mortality during 53 years’ follow-up of Swedish men and women

Abstract: Lower IQ was associated with an increased risk of mortality in men and women. The explanatory effects of socioeconomic factors in adulthood suggest that they constitute an important pathway in the association between IQ and mortality, especially in women.

Cited by 12 publications

References 36 publications

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a bidirectional and multivariable Mendelian randomization study with more than 815,000 participants

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a bidirectional and multivariable Mendelian randomization study with more than 815,000 participants

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a multivariable Mendelian randomization study with more than 815,000 participants

How intelligence and emotional control are related to suicidal behavior across the life course – A register-based study with 38-year follow-up

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