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Shared genetic and environmental etiology between substance use disorders and suicidal behavior

Published online by Cambridge University Press:  12 November 2021

Alexis C. Edwards Open the ORCID record for Alexis C. Edwards [Opens in a new window] ,
Henrik Ohlsson ,
Séverine Lannoy ,
Mallory Stephenson ,
Casey Crump ,
Jan Sundquist ,
Kristina Sundquist  and
Kenneth S. Kendler
Alexis C. Edwards*
Affiliation:
Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
Henrik Ohlsson
Affiliation:
Center for Primary Health Care Research, Lund University, Malmö, Sweden
Séverine Lannoy
Affiliation:
Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
Mallory Stephenson
Affiliation:
Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
Casey Crump
Affiliation:
Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Jan Sundquist
Affiliation:
Center for Primary Health Care Research, Lund University, Malmö, Sweden Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Kristina Sundquist
Affiliation:
Center for Primary Health Care Research, Lund University, Malmö, Sweden Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Kenneth S. Kendler
Affiliation:
Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
*
Author for correspondence: Alexis C. Edwards, E-mail: alexis.edwards@vcuhealth.org
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Abstract

Background

Previous studies have demonstrated substantial associations between substance use disorders (SUD) and suicidal behavior. The current study empirically assesses the extent to which shared genetic and/or environmental factors contribute to associations between alcohol use disorders (AUD) or drug use disorders (DUD) and suicidal behavior, including attempts and death.

Methods

The authors used Swedish national registry data, including medical, pharmacy, criminal, and death registrations, for a large cohort of twins, full siblings, and half siblings (N = 1 314 990) born 1960–1980 and followed through 2017. They conducted twin-sibling modeling of suicide attempt (SA) or suicide death (SD) with AUD and DUD to estimate genetic and environmental correlations between outcomes. Analyses were stratified by sex.

Results

Genetic correlations between SA and SUD ranged from rA = 0.60–0.88; corresponding shared environmental correlations were rC = 0.42–0.89 but accounted for little overall variance; and unique environmental correlations were rE = 0.42–0.57. When replacing attempt with SD, genetic and shared environmental correlations with AUD and DUD were comparable (rA = 0.48–0.72, rC = 0.92–1.00), but were attenuated for unique environmental factors (rE = −0.01 to 0.31).

Conclusions

These findings indicate that shared genetic and unique environmental factors contribute to comorbidity of suicidal behavior and SUD, in conjunction with previously reported causal associations. Thus, each outcome should be considered an indicator of risk for the others. Opportunities for joint prevention and intervention, while limited by the polygenic nature of these outcomes, may be feasible considering moderate environmental correlations between SA and SUD.

Keywords

Alcohol use disorderdrug use disordersubstance use disorderssuicidal behaviorsuicide attemptsuicide deathtwin modelingshared liability
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 6 , April 2023 , pp. 2380 - 2388
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

*

Joint senior authors.

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