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Suicidality and immigration: stress from migration or a “failed promise”?
Abstracts / Comprehensive Psychiatry 54 (2013) e15–e40 smoking have discovered genetic risks for other forms of psychopathology. Objective: To test the hypothesis that genetic risks discovered in GWAS of smoking behavior also predict other types of psychopathology. Design: Prospective longitudinal study of a complete birth cohort (n = 1,037) followed through age 38 years with 96% retention. Setting: The Dunedin Multidisciplinary Health and Development Study. Main exposures: We derived a multi-locus profile of genetic risk from metaanalyses of GWAS of smoking quantity. This “genetic risk score” was normally distributed in the cohort, demonstrated no sex differences, and was unrelated to the socioeconomic characteristics of the households where children grew up. Main outcome measures: We constructed a 3-factor model of psychopathology comprising an externalizing factor, an internalizing factor, and a thought disorder factor. The model used symptom-level data for DSM-IV disorders collected during in-person interviews when cohort members were aged 18, 21, 26, 32, and 38 years. The externalizing factor comprised conduct disorder, alcohol dependence, nicotine dependence, cannabis dependence, and hard drug dependence. The internalizing factor comprised major depression, generalized anxiety disorder, panic disorder, and phobias. The thought disorder factor comprised obsessive compulsive disorder, mania, and schizophrenia. The model fit the data very well. Results: Cohort members at higher genetic risk for smoking problems were also at increased risk to manifest externalizing disorders, internalizing disorders, and thought disorders. Effect sizes were uniformly small but statistically significant (p b 0.05 for all). Conclusions: Genetic risks discovered in GWAS of smoking behavior may influence the etiologies of other types of psychopathology. Replication in additional cohorts is needed. http://dx.doi.org/10.1016/j.comppsych.2013.07.007
Suicidality and immigration: stress from migration or a “failed promise”? M.J. Brown a, S.A. Cohena, B. Mezuk a a Richmond, VA Background: Suicide was the tenth leading cause of death in the United States among persons ages 10 and over in 2009. Suicide ideation varies for NonHispanic Whites, Non-Hispanic Blacks and Hispanics. However, the prevalence of suicide attempts has been found to be similar among these groups. There has been a rapid increase in immigration of minority populations to the US. However, literature on suicidality and immigration in the US is scant. Research on suicidal behavior is warranted so as to better understand the risk factors of suicide among minority populations. The objective of this study was to determine the association between suicidality and years in the US among Afro-Caribbean, Asian, and Latino immigrants living in the US. Methods: Data were obtained from the 2001–2003 Collaborative Psychiatric Epidemiology Surveys, National Survey of American Life and the National Latino and Asian American Study. Years in the US (b5, 5–10, 11–20, N20 years) was the primary exposure variable. Suicide ideation and attempts were the primary outcome variables. Logistic regression was used to obtain odds ratios and 95% confidence intervals to determine the association between years in the US and suicidality among Afro-Caribbean, Asian, and Latino immigrant populations. Adjusted models controlled for educational status, income-to-needs ratio, marital status, gender, age of migration, lifetime major depressive disorder, dysthymia, generalized anxiety disorder, alcohol and drug abuse and dependence. Results: Among Latinos there was a positive association between time in the US and suicidal ideation (Plinear trend = 0.001) and attempts (Plinear trend = 0.012). Compared to individuals who had been in the US b5 years, those who have been here N20 years had 2.61 greater odds (95% CI: 1.23–5.55) of suicidal ideation. There was no significant association between years in the US and suicidal behavior among Afro-Caribbeans and a modest positive association among Asians (Plinear trend = 0.018 for ideation; Plinear trend = 0.063 for attempts). Conclusion: The findings from Latinos and Asians support the “failed promise” hypothesis. Studies have shown that acculturation can be a risk factor and a
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protective factor for suicidality – a risk factor due to the erosion of coping strategies and cultural values; and a protective factor due to better social integration. The results from the current study suggest that acculturation might not be universal across racial/ethnic groups. Suicide and intervention programs for immigrants may need to be tailored differently depending on the target racial/ ethnic group and time in the US.
http://dx.doi.org/10.1016/j.comppsych.2013.07.008
Childhood maltreatment is associated with epigenetic differences in hypothalamic-pituitary-adrenal (HPA) axis genes in the Detroit Neighborhood Health Study Angela C. Bustamante a, Allison E. Aiello b, Karestan C. Koenen c, Sandro Galea c, Carol Noronha d, Derek Wildman a, Monica Uddin a,e a Center for Molecular Medicine and Genetics Wayne State University School of Medicine, Detroit, MI b University of Michigan School of Public Health, Ann Arbor, MI c Columbia University Mailman School of Public Health, New York, NY d Wayne State University, Detroit, MI e Department of Psychiatry & Behavioral Neuroscience Wayne State University, Detroit, MI Background: Recent work suggests that early life adversity causes longlasting epigenetic changes in genes within the hypothalamic-pituitaryadrenal (HPA) axis. Previous human studies have examined epigenetic differences in HPA axis gene NR3C1, the glucocorticoid receptor, and gene environment interactions in another HPA axis gene, FKBP5, FK506 binding protein. Both are involved in regulation of the HPA axis stress response and have been linked to depression. Childhood maltreatment (CM) is known to increase susceptibility to depression later in life; and, although depression is also associated with epigenetic changes at HPA axis genes, the molecular mechanisms contributing to increased CM-depression risk remain poorly understood. We investigate the joint and interacting effects of CM and depression on DNA methylation (DNAm) and gene expression in HPA axis genes. Methods: A subset of participants (n = 112) was drawn from a populationbased cohort of adults, the Detroit Neighborhood Health Study. Selection was based on availability of whole-blood-derived DNA, leukocyte-derived RNA, CM exposure, and depression data. CM exposure and depression data were collected via structured telephone interviews using previously validated instruments that assessed severity, duration, and frequency of CM and depression. Participants were stratified into four groups: high CM/ no depression, low CM/no depression, high CM/depression, and low CM/ depression. Pyrosequencing assessed DNAm in the promoter regions of NR3C1 and FKBP5; Taqman assays measured gene expression. Data were analyzed using paired T-tests and two-way ANOVAs in SPSS. Results: Two-way ANOVAs detected significantly higher (p b 0.05) DNAm in NR3C1 CpG sites unique to CM and depression, respectively. Specifically, the putative NGFI-A TFBS had significantly (p b 0.05) higher DNAm for CM, whereas significantly higher DNAm was detected at adjacent CpG sites for depression. Paired t-tests showed marginal decreases (p b 0.06) in NR3C1 gene expression levels for CM vs. controls. FKBP5 DNAm levels were not significantly (p N 0.05) higher in participants with vs. without CM. Paired t-tests for FKBP5 gene expression did not show significant differences for CM vs. controls. No significant CM-depression interactions on DNAm were detected in either gene. Conclusions: Our data suggest depression and CM are jointly associated with epigenetic differences at distinct CpG sites in HPA axis genes, with CM effects lasting into adulthood. Further work is necessary to elucidate the molecular mechanisms by which CM may contribute to depression and may assist with development of targeted therapies and treatments for patients with a history of CM and/or depression. http://dx.doi.org/10.1016/j.comppsych.2013.07.009
Suicidality and immigration: stress from migration or a “failed promise”? M.J. Brown a, S.A. Cohena, B. Mezuk a a Richmond, VA Background: Suicide was the tenth leading cause of death in the United States among persons ages 10 and over in 2009. Suicide ideation varies for NonHispanic Whites, Non-Hispanic Blacks and Hispanics. However, the prevalence of suicide attempts has been found to be similar among these groups. There has been a rapid increase in immigration of minority populations to the US. However, literature on suicidality and immigration in the US is scant. Research on suicidal behavior is warranted so as to better understand the risk factors of suicide among minority populations. The objective of this study was to determine the association between suicidality and years in the US among Afro-Caribbean, Asian, and Latino immigrants living in the US. Methods: Data were obtained from the 2001–2003 Collaborative Psychiatric Epidemiology Surveys, National Survey of American Life and the National Latino and Asian American Study. Years in the US (b5, 5–10, 11–20, N20 years) was the primary exposure variable. Suicide ideation and attempts were the primary outcome variables. Logistic regression was used to obtain odds ratios and 95% confidence intervals to determine the association between years in the US and suicidality among Afro-Caribbean, Asian, and Latino immigrant populations. Adjusted models controlled for educational status, income-to-needs ratio, marital status, gender, age of migration, lifetime major depressive disorder, dysthymia, generalized anxiety disorder, alcohol and drug abuse and dependence. Results: Among Latinos there was a positive association between time in the US and suicidal ideation (Plinear trend = 0.001) and attempts (Plinear trend = 0.012). Compared to individuals who had been in the US b5 years, those who have been here N20 years had 2.61 greater odds (95% CI: 1.23–5.55) of suicidal ideation. There was no significant association between years in the US and suicidal behavior among Afro-Caribbeans and a modest positive association among Asians (Plinear trend = 0.018 for ideation; Plinear trend = 0.063 for attempts). Conclusion: The findings from Latinos and Asians support the “failed promise” hypothesis. Studies have shown that acculturation can be a risk factor and a
e17
protective factor for suicidality – a risk factor due to the erosion of coping strategies and cultural values; and a protective factor due to better social integration. The results from the current study suggest that acculturation might not be universal across racial/ethnic groups. Suicide and intervention programs for immigrants may need to be tailored differently depending on the target racial/ ethnic group and time in the US.
http://dx.doi.org/10.1016/j.comppsych.2013.07.008
Childhood maltreatment is associated with epigenetic differences in hypothalamic-pituitary-adrenal (HPA) axis genes in the Detroit Neighborhood Health Study Angela C. Bustamante a, Allison E. Aiello b, Karestan C. Koenen c, Sandro Galea c, Carol Noronha d, Derek Wildman a, Monica Uddin a,e a Center for Molecular Medicine and Genetics Wayne State University School of Medicine, Detroit, MI b University of Michigan School of Public Health, Ann Arbor, MI c Columbia University Mailman School of Public Health, New York, NY d Wayne State University, Detroit, MI e Department of Psychiatry & Behavioral Neuroscience Wayne State University, Detroit, MI Background: Recent work suggests that early life adversity causes longlasting epigenetic changes in genes within the hypothalamic-pituitaryadrenal (HPA) axis. Previous human studies have examined epigenetic differences in HPA axis gene NR3C1, the glucocorticoid receptor, and gene environment interactions in another HPA axis gene, FKBP5, FK506 binding protein. Both are involved in regulation of the HPA axis stress response and have been linked to depression. Childhood maltreatment (CM) is known to increase susceptibility to depression later in life; and, although depression is also associated with epigenetic changes at HPA axis genes, the molecular mechanisms contributing to increased CM-depression risk remain poorly understood. We investigate the joint and interacting effects of CM and depression on DNA methylation (DNAm) and gene expression in HPA axis genes. Methods: A subset of participants (n = 112) was drawn from a populationbased cohort of adults, the Detroit Neighborhood Health Study. Selection was based on availability of whole-blood-derived DNA, leukocyte-derived RNA, CM exposure, and depression data. CM exposure and depression data were collected via structured telephone interviews using previously validated instruments that assessed severity, duration, and frequency of CM and depression. Participants were stratified into four groups: high CM/ no depression, low CM/no depression, high CM/depression, and low CM/ depression. Pyrosequencing assessed DNAm in the promoter regions of NR3C1 and FKBP5; Taqman assays measured gene expression. Data were analyzed using paired T-tests and two-way ANOVAs in SPSS. Results: Two-way ANOVAs detected significantly higher (p b 0.05) DNAm in NR3C1 CpG sites unique to CM and depression, respectively. Specifically, the putative NGFI-A TFBS had significantly (p b 0.05) higher DNAm for CM, whereas significantly higher DNAm was detected at adjacent CpG sites for depression. Paired t-tests showed marginal decreases (p b 0.06) in NR3C1 gene expression levels for CM vs. controls. FKBP5 DNAm levels were not significantly (p N 0.05) higher in participants with vs. without CM. Paired t-tests for FKBP5 gene expression did not show significant differences for CM vs. controls. No significant CM-depression interactions on DNAm were detected in either gene. Conclusions: Our data suggest depression and CM are jointly associated with epigenetic differences at distinct CpG sites in HPA axis genes, with CM effects lasting into adulthood. Further work is necessary to elucidate the molecular mechanisms by which CM may contribute to depression and may assist with development of targeted therapies and treatments for patients with a history of CM and/or depression. http://dx.doi.org/10.1016/j.comppsych.2013.07.009