The largest genome wide association study (GWAS) to date on suicide attempt reveals that genetic liability to depression increases an individual's risk for suicide attempt regardless of the psychiatric disorder they are affected by, according to the work led by researchers at the Icahn School of Medicine at Mount Sinai and published June 5 in The American Journal of Psychiatry.

Suicide is a worldwide public health problem with more than 800,000 deaths due to suicide each year. Suicide and suicide attempts have an emotional toll on families and friends of those who died, as well as on attempt survivors. The Centers for Disease Control and Prevention report that suicide costs the US economy $51 billion per year in medical costs for individuals and families, lost income for families, and lost productivity for employers. These stark figures highlight the urgent need for improved prevention and treatment, yet progress has been hampered by the lack of reliable methods for predicting suicidality and a poor understanding of its biological etiology.

"Like many psychiatric disorders, suicide attempt is known to have a partially genetic underpinning and genetic studies can provide invaluable insights into the underlying biology," says Niamh Mullins, PhD, Postdoctoral Fellow in Psychiatric Genomics. "Through the collective efforts of many researchers, we analyzed the genomes of suicide attempters and non-attempters across three major psychiatric disorders. Our data showed that suicide attempters with major depressive disorder, bipolar disorder or a schizophrenia diagnosis carry a greater genetic liability for major depression than non-attempters."

Specifically, the current study compared the genomes of 6,569 suicide attempters and 17,232 non-attempters with major depressive disorder, bipolar disorder, or schizophrenia from the Psychiatric Genomics Consortium, an international collaboration for conducting large-scale genetic studies of psychiatric disorders. Samples were combined across 46 individual cohorts from Europe, the United States, and Australia. Using polygenic risk scores, which summarize an individual's genetic liability to a disease based on the results of an independent genetic study, the research team showed that suicide attempters carry an increased genetic liability for depression, regardless of the psychiatric disorder they are affected by.

"These results indicate the existence of a shared genetic etiology between suicide attempt and major depression that is common to suicide attempt in different psychiatric disorders," says Dr. Mullins. "Our study is the first consortium-based GWAS on suicide attempt and makes significant progress in increasing numbers by combining samples across clinical cohorts. However, further collaborative efforts to amass samples on an even larger scale will be essential to identify specific genetic variants which play a role in increasing risk of suicide attempt."

This study provides novel insights into the genetic basis of suicide attempt. The ultimate goal of this research is to undercover the biological mechanisms underlying suicidality and develop new treatments and preventions, in order to reduce its burden on patients, families and healthcare systems.

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Kings College London and many other research institutions contributed data to the study through the Psychiatric Genomics Consortium, which has received major funding from the National Institute of Mental Health and the National Institute of Drug Abuse.

About the Mount Sinai Health System

The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 18 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Gastroenterology/GI Surgery, Geriatrics, Nephrology, and Neurology/Neurosurgery, and in the top 50 in six other specialties in the 2018-2019 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 11th nationally for Ophthalmology and 44th for Ear, Nose, and Throat. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and South Nassau Communities Hospital are ranked regionally.