Influence of Sex on Suicidal Phenotypes in Affective Disorder Patients with Traumatic Childhood Experiences

Abstract

ObjectivesIn the current study, we aimed to investigate the impact of childhood trauma on suicidal behaviour phenotypes in a group of patients with diagnosed affective disorder (unipolar or bipolar affective disorder).Patients and MethodsPatients with and without a history of childhood abuse, measured by Childhood Trauma Questionnaire (CTQ), were assessed to explore risks for suicidal behaviour (including suicide attempt, self-harm and non-suicidal self-injury). The tested sample consisted of 258 patients (111 males and 147 females, in-patients and out-patients at the Department of Psychiatry and Psychotherapy, Medical University of Vienna and University Hospital Tulln, Lower Austria). Psychiatric diagnoses were derived from the SCAN (Schedules for Clinical Assessment in Neuropsychiatry) interview. In addition, patients were administered the Lifetime Parasuicidal Count (LPC), Suicidal Behaviour Questionnaire (SBQ-R), and Viennese Suicide Risk Assessment Scale (VISURIAS) questionnaires.ResultsIn contrast to male suicide attempters, female suicide attempters showed both significantly higher total CTQ scores (p<0.001), and higher CTQ subscores (emotional, physical and sexual abuse, as well as emotional and physical neglect) in comparison to the non-suicidal control group. Besides, females with a history of self-harming behaviour (including suicidal intention) and Non-Suicidal-Self Injury (NSSI) had significantly higher CTQ total scores (p<0.001) than the control group.ConclusionThese findings suggest gender differences in suicidal behaviour after being exposed to childhood trauma.

The Impact of COMT and Childhood Maltreatment on Suicidal Behaviour in Affective Disorders

“…We found an association with suicidal behaviour and the SNP rs737865, with a risk increasing effect for suicide attempt in males (p value = 0.006 [0.030 after multiple testing correction] (Table 1 ). Gender differences in suicidal behaviour and depression were also suggested in other studies 16 , 21 . For instance, Aberg et al .…”

“…In the present study we observed that the haplotype GAT of rs737865, rs6269, rs4633 is significantly associated with suicide attempt (p = 0.003 [0.021 after multiple testing correction]), and that there is a tendency towards self-harming behaviour (p = 0.02 [0.08 after multiple testing correction]) and also NSSI (p = 0.03 [0.08 after multiple testing correction]), though the p values did not resist multiple testing correction. Based on previously published findings 21 , in gene x environment haplotypic analyses, we focused on sexual abuse as the strongest environmental factor. Interestingly in the gene x environment regression model to investigate suicide risk, sexual abuse and the haplotype GAT were significantly associated with suicide risk, but not the interaction of these two factors (Table 4 ).…”

“…Suicidal behaviour is a very complex phenotype, therefore it should be classified by distinguishing between suicidal thoughts/ideation, self-harm (with or without intent to die), NSSI (non-suicidal self-injury), suicide attempts and completed suicide 19 , 20 . In a previous study, distinguishing in these suicidal phenotypes, results showed that different types of childhood maltreatment lead to different suicidal phenotypes later in life 21 . Turecki and Brent introduced a similar classification of suicidal phenotypes in order to standardise the nomenclature of suicidal behaviour 22 .…”

The Relationship between Childhood Maltreatment and Non-Suicidal Self-Injury: A Systematic Review

“…Similar results were documented by Martin and colleagues in a more recent study ( 19 ) in which NSSI behavior was linked with perceived CM. Bernegger et al ( 20 ) analyzed a sample of adults with unipolar or bipolar affective disorder and found that childhood sexual abuse was a risk factor for suicide attempts but not for self-harm in adulthood. In that study, females who engaged in self-harming behavior (including suicidal intention) or NSSI had significantly higher CTQ scores than controls.…”

A study on the association of psychiatric diagnoses and childhood adversities with suicide risk

“…Contrary to several previous studies [9,16,43,44], sexual abuse was not associated with suicide risk in the present study. However, in a prospective cohort of street youth, it was found that physical abuse, emotional abuse, and emotional neglect, but not sexual abuse, associated with suicide attempts in adjusted analyses [45]. It is possible that the association between sexual abuse and risk of suicide varies between cultures.…”