Familial Aggregation of Suicide Attempts Linked to Comorbid Mental Conditions

A familial predisposition to social anxiety may provide insight into the mechanisms and prevention of suicide.

A familial pattern of suicide attempts is explained by a history of mental disorders among those who attempt suicide, according to the results of a study published in JAMA Psychiatry. The study also found that there is an association between social anxiety and suicide attempts in relatives.

Each year more than 44,000 Americans die by suicide. Identifying individuals at high risk for attempts is a major concern. Although previous studies have attempted to determine the role played by familial factors, most have had small samples sizes or limited assessment of mental disorders in probands and relatives.

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Elizabeth D. Ballard, PhD, from the Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institutes of Health, Bethesda, Maryland, and colleagues used data obtained from 2 parallel community-based family studies on the comorbidity of mood and anxiety disorders: 1 conducted in the United States and the other in Lausanne, Switzerland. Lifetime suicide attempts and mental disorders in first-degree relatives were the outcome measures. They collected and analyzed data from October 2004 to December 2016.

The study included 1119 adult probands and 5355 first-degree relatives. Among these groups, 8.0% of probands and 3.7% of relatives had a lifetime history of suicide attempt. Mood disorders and substance use disorders had a significant association with suicide attempts. However, the familial association between lifetime suicide attempts in probands and relatives was not statistically significant after adjusting for comorbid conditions in both groups. In contrast, social anxiety disorder in probands was associated with suicide attempts in relatives with an odds ratio of 2.4 after controlling for comorbid mood, anxiety, and substance use disorders.

“[T]he novel finding of a common familial diathesis for suicide attempts and social anxiety, particularly in combination with mood disorders, has heuristic value for future research and may be a risk marker that can inform prevention efforts,” the investigators concluded.


Ballard ED, Cui L, Vandeleur C, et al. Familial aggregation and coaggregation of suicide attempts and comorbid mental disorders in adults [published online March 27, 2019]. JAMA Psychiatry. 2019. doi:10.1001/jamapsychiatry.2019.0248.