Genetic and Psychosocial Risk Factors Associated with Suicide Among Community Veterans: Implications for Screening, Treatment and Precision Medicine
Joseph A Boscarino,1 Richard E Adams,2 Thomas G Urosevich,3 Stuart N Hoffman,4 H Lester Kirchner,1 Xin Chu,5 Weixing Shi,5 Joseph J Boscarino,6 Ryan J Dugan,1 Carrie A Withey,1 Charles R Figley7 1Department Population Health Sciences, Geisinger Clinic, Danville, PA, 17822, USA; 2Department Sociology...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-01-01
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| Series: | Pharmacogenomics and Personalized Medicine |
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| Online Access: | https://www.dovepress.com/genetic-and-psychosocial-risk-factors-associated-with-suicide-among-co-peer-reviewed-fulltext-article-PGPM |
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| author | Boscarino JA Adams RE Urosevich TG Hoffman SN Kirchner HL Chu X Shi W Boscarino JJ Dugan RJ Withey CA Figley CR |
| author_facet | Boscarino JA Adams RE Urosevich TG Hoffman SN Kirchner HL Chu X Shi W Boscarino JJ Dugan RJ Withey CA Figley CR |
| author_sort | Boscarino JA |
| collection | DOAJ |
| description | Joseph A Boscarino,1 Richard E Adams,2 Thomas G Urosevich,3 Stuart N Hoffman,4 H Lester Kirchner,1 Xin Chu,5 Weixing Shi,5 Joseph J Boscarino,6 Ryan J Dugan,1 Carrie A Withey,1 Charles R Figley7 1Department Population Health Sciences, Geisinger Clinic, Danville, PA, 17822, USA; 2Department Sociology, Kent State University, Kent, OH, 44242, USA; 3Ophthalmology Service, Geisinger Clinic, Mount Pocono, PA, 18344, USA; 4Department Sleep Medicine, Geisinger Clinic, Danville, PA, 17822, USA; 5Obesity Institute, Geisinger Clinic, Danville, PA, 17822, USA; 6Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, STC 7, Tampa, FL, 33606, USA; 7School of Social Work, Tulane University, New Orleans, LA, 70112, USACorrespondence: Joseph A BoscarinoDepartment Population Health Sciences, Geisinger Clinic, 100 N. Academy Ave., 44-00, Danville, PA, 17822, USATel +1 570-214-9825Email joseph.boscarino@gmail.comIntroduction: Since veteran suicide is a concern and our knowledge of predictive factors is still limited, our objective was to assess risk factors for suicide, including genetic factors, among deployed veterans.Methods: For this study, we surveyed 1730 veterans who were outpatients in a multi-hospital system in Pennsylvania. Altogether, 1041 veterans (60%) provided a DNA sample. The genetic risk variants investigated were within loci previously associated with PTSD and substance misuse, including CRHR1, CHRNA5, RORA, and FKBP5 genetic variations, which were used to calculate a polygenic risk score (range=0– 8, mean=3.6, SD=1.4).Results: Most veterans (56.2%) were deployed to Vietnam while significant numbers were deployed to Iraq, Afghanistan, and other post-Vietnam conflicts. Overall, 95.1% of the veterans were male, their mean age was 56.2 (SD=12), and 95.6% were Caucasian. Among the veterans, 24% had high combat exposure. The prevalence of lifetime suicidal thoughts was 11.3%. Additionally, 5.7% ever developed a suicide plan or attempted suicide in their lifetimes. Among those with a history of a lifetime suicide attempt or suicide plan, the PTSD genetic risk score was significantly higher (OR=3.96 vs 3.55, p=0.033), but for suicidal thoughts, this association was not significant (p=0.717). In multivariable analysis (MVA) logistic regression, significant predictors of attempting suicide or having a suicide plan were history of depression (OR=5.04, p< 0.001), PTSD genetic risk score (OR=1.25, p=0.036), history of childhood abuse/neglect (OR=2.24, p=0.009), and lifetime marijuana use (OR= 1.56, p=0.020). Conversely, rural residence was protective for suicide risk (OR=0.49; p=0.031). For suicidal thoughts, in the MVA genetic risk score was not significant (p=0.697), but history of child abuse/neglect (p< 0.001), history of depression (p> 0.001), low psychological resilience (p=0.004), and lifetime marijuana use (p=0.022) were significant.Discussion: In this study, we identified genetic risk variants and other predictors for suicide among veterans that may have implications for future screening and clinical care. Further research is advised.Keywords: veterans, warzone deployment, suicide, genetic factors, patient screening, precision medicine |
| first_indexed | 2024-12-18T04:56:13Z |
| format | Article |
| id | doaj.art-00034314025f4207b1c5673f67a9cabe |
| institution | Directory Open Access Journal |
| issn | 1178-7066 |
| language | English |
| last_indexed | 2024-12-18T04:56:13Z |
| publishDate | 2022-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Pharmacogenomics and Personalized Medicine |
| spelling | doaj.art-00034314025f4207b1c5673f67a9cabe2022-12-21T21:20:16ZengDove Medical PressPharmacogenomics and Personalized Medicine1178-70662022-01-01Volume 15172772293Genetic and Psychosocial Risk Factors Associated with Suicide Among Community Veterans: Implications for Screening, Treatment and Precision MedicineBoscarino JAAdams REUrosevich TGHoffman SNKirchner HLChu XShi WBoscarino JJDugan RJWithey CAFigley CRJoseph A Boscarino,1 Richard E Adams,2 Thomas G Urosevich,3 Stuart N Hoffman,4 H Lester Kirchner,1 Xin Chu,5 Weixing Shi,5 Joseph J Boscarino,6 Ryan J Dugan,1 Carrie A Withey,1 Charles R Figley7 1Department Population Health Sciences, Geisinger Clinic, Danville, PA, 17822, USA; 2Department Sociology, Kent State University, Kent, OH, 44242, USA; 3Ophthalmology Service, Geisinger Clinic, Mount Pocono, PA, 18344, USA; 4Department Sleep Medicine, Geisinger Clinic, Danville, PA, 17822, USA; 5Obesity Institute, Geisinger Clinic, Danville, PA, 17822, USA; 6Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, STC 7, Tampa, FL, 33606, USA; 7School of Social Work, Tulane University, New Orleans, LA, 70112, USACorrespondence: Joseph A BoscarinoDepartment Population Health Sciences, Geisinger Clinic, 100 N. Academy Ave., 44-00, Danville, PA, 17822, USATel +1 570-214-9825Email joseph.boscarino@gmail.comIntroduction: Since veteran suicide is a concern and our knowledge of predictive factors is still limited, our objective was to assess risk factors for suicide, including genetic factors, among deployed veterans.Methods: For this study, we surveyed 1730 veterans who were outpatients in a multi-hospital system in Pennsylvania. Altogether, 1041 veterans (60%) provided a DNA sample. The genetic risk variants investigated were within loci previously associated with PTSD and substance misuse, including CRHR1, CHRNA5, RORA, and FKBP5 genetic variations, which were used to calculate a polygenic risk score (range=0– 8, mean=3.6, SD=1.4).Results: Most veterans (56.2%) were deployed to Vietnam while significant numbers were deployed to Iraq, Afghanistan, and other post-Vietnam conflicts. Overall, 95.1% of the veterans were male, their mean age was 56.2 (SD=12), and 95.6% were Caucasian. Among the veterans, 24% had high combat exposure. The prevalence of lifetime suicidal thoughts was 11.3%. Additionally, 5.7% ever developed a suicide plan or attempted suicide in their lifetimes. Among those with a history of a lifetime suicide attempt or suicide plan, the PTSD genetic risk score was significantly higher (OR=3.96 vs 3.55, p=0.033), but for suicidal thoughts, this association was not significant (p=0.717). In multivariable analysis (MVA) logistic regression, significant predictors of attempting suicide or having a suicide plan were history of depression (OR=5.04, p< 0.001), PTSD genetic risk score (OR=1.25, p=0.036), history of childhood abuse/neglect (OR=2.24, p=0.009), and lifetime marijuana use (OR= 1.56, p=0.020). Conversely, rural residence was protective for suicide risk (OR=0.49; p=0.031). For suicidal thoughts, in the MVA genetic risk score was not significant (p=0.697), but history of child abuse/neglect (p< 0.001), history of depression (p> 0.001), low psychological resilience (p=0.004), and lifetime marijuana use (p=0.022) were significant.Discussion: In this study, we identified genetic risk variants and other predictors for suicide among veterans that may have implications for future screening and clinical care. Further research is advised.Keywords: veterans, warzone deployment, suicide, genetic factors, patient screening, precision medicinehttps://www.dovepress.com/genetic-and-psychosocial-risk-factors-associated-with-suicide-among-co-peer-reviewed-fulltext-article-PGPMveteranswarzone deploymentsuicidegenetic factorspatient screeningprecision medicine |
| spellingShingle | Boscarino JA Adams RE Urosevich TG Hoffman SN Kirchner HL Chu X Shi W Boscarino JJ Dugan RJ Withey CA Figley CR Genetic and Psychosocial Risk Factors Associated with Suicide Among Community Veterans: Implications for Screening, Treatment and Precision Medicine Pharmacogenomics and Personalized Medicine veterans warzone deployment suicide genetic factors patient screening precision medicine |
| title | Genetic and Psychosocial Risk Factors Associated with Suicide Among Community Veterans: Implications for Screening, Treatment and Precision Medicine |
| title_full | Genetic and Psychosocial Risk Factors Associated with Suicide Among Community Veterans: Implications for Screening, Treatment and Precision Medicine |
| title_fullStr | Genetic and Psychosocial Risk Factors Associated with Suicide Among Community Veterans: Implications for Screening, Treatment and Precision Medicine |
| title_full_unstemmed | Genetic and Psychosocial Risk Factors Associated with Suicide Among Community Veterans: Implications for Screening, Treatment and Precision Medicine |
| title_short | Genetic and Psychosocial Risk Factors Associated with Suicide Among Community Veterans: Implications for Screening, Treatment and Precision Medicine |
| title_sort | genetic and psychosocial risk factors associated with suicide among community veterans implications for screening treatment and precision medicine |
| topic | veterans warzone deployment suicide genetic factors patient screening precision medicine |
| url | https://www.dovepress.com/genetic-and-psychosocial-risk-factors-associated-with-suicide-among-co-peer-reviewed-fulltext-article-PGPM |
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