{"id":2903,"date":"2014-09-10T12:30:28","date_gmt":"2014-09-10T16:30:28","guid":{"rendered":"http:\/\/blogs.cdc.gov\/genomics\/?p=2903"},"modified":"2024-04-08T16:24:02","modified_gmt":"2024-04-08T20:24:02","slug":"suicide","status":"publish","type":"post","link":"https:\/\/blogs.cdc.gov\/genomics\/2014\/09\/10\/suicide\/","title":{"rendered":"Suicide, Family History, and Genomics"},"content":{"rendered":"

We must continue to search for new methods to effectively address the tremendous problem of suicide. Despite recent interest<\/strong>, genomics does not provide the solution today, but there is a lot that we can do now using an established public health approach to prevention.<\/strong><\/h4>\n

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Millions were shocked by the news that comedian Robin Williams had died by suicide<\/a>. The star is remembered for more than just his energetic roles but also his work to help charitable causes and to entertain U.S. troops<\/a> abroad. But the joy he gave to others stood in sharp contrast to the challenges he faced in his own life: depression, addiction, and more recently Parkinson’s Disease<\/a>. The revelations brought many to contemplate what more could be done to identify the risks and prevent suicide and what hope, if any, emerging fields of science like genomics might offer.<\/p>\n

\"Robin<\/a><\/p>\n

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Suicide: A Substantial Public Health Problem<\/strong><\/h2>\n

Williams\u2019 suicide at the age of 63 will be recorded as one of thousands of deaths in the U.S. this year alone in his age group. Death from suicide among those aged 60-64 rose 37% from 1999 to 2010.<\/a> In fact, suicide is the 5th<\/sup> leading cause of death in the United States among middle-aged adults<\/a> (ages 35-64 years). Suicide is far more common as a cause of death<\/a> than homicide, HIV\/AIDS, or hypertension, and\u00a0in 2009, the number of deaths from suicide surpassed deaths from motor vehicle crashes in the U.S<\/a>. Each year, more than 39,000 Americans take their own lives and about 487,000 people receive medical care for self-inflicted injuries. At the family level, suicide is a devastating tragedy with lasting implications for loved ones; at the population level<\/a> it comprises an incomprehensible and needless loss of human life and capacity. By very definition suicide is preventable. Yet many people are uncomfortable even talking about suicide in part because of the blame, guilt, and stigma<\/a> that often follows it.<\/p>\n

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Suicide: Depression But Also Many Other Factors<\/strong><\/h2>\n

Major depressive disorder (MDD) is the second leading cause of disability worldwide<\/a> and an important contributor<\/a> to the burden of suicide. Millions of adults in the U.S. are considered to be in less than optimum mental health, largely because of depression and substance abuse problems. While there has been more focus on people with mental illness in recent decades,<\/a> the proportion of individuals who actually receive care for depression and other conditions is low and those who do seek care usually do so many years after onset. In the U.S. it is estimated that 67% of persons suffering from mental illness are not treated, compared<\/a> with a treatment gap of only 8% for diabetes. The U.S. Preventive Services Task Force recommends screening adults, and adolescents for depression in appropriate care settings.<\/p>\n

Long-term studies of persons hospitalized at least once with MDD suggest that perhaps 1 in 10 will die by suicide<\/a>. The rate of suicide in never-hospitalized persons with MDD may be lower.\u00a0 However, if most people suffering from depression will never tragically end their own lives what are the other important contributing factors? Also, if most people suffering from depression are not diagnosed or receiving care, are there other ways to identify those at greatest risk?<\/p>\n

Indeed the causes of suicide are often complex, and multiple. There are many other environmental stressors beyond depression that contribute to suicide including problems with relationships, career, other medical issues, and financial problems. All of the potential factors are important to understand including some controversial topics such as the effects of prescription SSRI medications; substance abuse<\/a>; and the best ways to treat post-traumatic stress disorders including among<\/a> veterans. Increasingly the desire to better understand the complicated causal relationships of suicide has led researchers to consider genomics as part of the equation.<\/p>\n

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Suicide, Genetics, and Family History<\/strong><\/h2>\n

Research studies have been conducted in an attempt to identify genetic differences associated with suicide risk, and today, these efforts are in an exploratory stage. However, 200 genes have been associated with suicide risk, including results from 10<\/a> genome-wide association studies. While there are <\/strong>genetic tests<\/strong><\/a> presently marketed for the purpose of identifying people at risk, these applications have not yet been validated and <\/strong>do not contain enough information to accurately predict who will attempt suicide. <\/strong><\/a>\u00a0<\/strong>Despite research potential in an appropriate setting, there is inadequate evidence that genetic-based psychological tests are ready for use in practice. <\/strong><\/p>\n

Like most health issues, the best understanding of the causes of suicide comes through the broad prism of gene\/environment interaction: that health outcomes and the choices people make are greatly influenced by the dynamic interaction of both genes and environment<\/a>. It is therefore not surprising that risk factors include a family history of suicide<\/a>. Immediate family members share not only genes but diet, living conditions, economic status, social values, and behavioral issues, which can all combine in a powerful way. It may be important for primary and mental health providers to know about a patient\u2019s family history of suicide<\/a> and depression<\/a>.<\/p>\n

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The Best Prevention Strategy Today <\/strong><\/h2>\n

CDC takes an evidence-based, public health approach to prevent suicide<\/a>, which includes using data to: identify populations at higher risk of suicide and to support the development and evaluation of suicide prevention interventions. Promising interventions are best designed and evaluated with an understanding of the risk factors\/warning signs and protective factors. Finally, the public health role includes promoting this knowledge to health care providers, special populations at highest risk, and the general public.<\/p>\n

1 Know the Risk Factors<\/strong><\/h3>\n

Risk factors include:<\/strong><\/a><\/p>\n