Serotonin transporter gene polymorphism as a predictor of short-term risk of suicide reattempts

• Published in: European psychiatry Vol. 54; pp. 19 - 26
• Main Authors: Daray, Federico M., Arena, Ángeles R., Armesto, Arnaldo R., Rodante, Demián E., Puppo, Soledad, Vidjen, Patricia, Portela, Alicia, Grendas, Leandro N., Errasti, Andrea E.
• Format: Journal Article
• Language: English
• Published: England Elsevier Masson SAS 01.10.2018
• Subjects: 5-HTTLPR; Adult; Female; Follow-Up Studies; Genotype; Humans; Impulsivity; Male; Polymorphism; Polymorphism, Genetic; Predictor; Promoter Regions, Genetic - genetics; Prospective Studies; Serotonin; Serotonin Plasma Membrane Transport Proteins - genetics; Suicidal Ideation; Suicide behavior; Suicide, Attempted; Impulsivity; Suicide behavior; 5-HTTLPR; Serotonin; Predictor; Polymorphism
• ISSN: 0924-9338; 1778-3585; 1778-3585
• DOI: 10.1016/j.eurpsy.2018.07.001

The serotonin-transporter-linked polymorphic region (5-HTTLPR) polymorphisms are associated with suicidal behavior; however, prospective studies are scarce. Herein we aim to determine if 5-HTTLPR polymorphisms predict risk of short-term suicide reattempt in a high-risk suicidal sample. We also explore possible mediators or moderators of this relationship. A multicenter prospective cohort study was designed to compare data obtained form 136 patients admitted to the emergency department for current suicidal ideation or a recent suicide attempt. Subjects were clinically evaluated, genotyped, and monitored for a new suicide attempt for 6 months. At 6 months of follow up, 21% of the subjects had a new suicide attempt. The frequency of L-allele and L-carrier was higher in reattempters when compared with non-reattempters (55.8% vs. 35.4%, p =  0.01 and 76.9% vs. 54.2%, p = 0.04, respectively). Reattempters also differ from non-reattempters patients with respect to age, history of previous suicide attempts, and age of onset of suicidal behavior. The logistic regression model showed that L-carriers had an odds ratio of 2.8 (95% CI: 1.0–7.6) for reattempts when compared to SS genotype. The adjusted model indicates that this association is not mediated or moderated by impulsivity. The 5-HTTLPR polymorphisms predicted short-term risk of suicidal reattempt independently of age and sex. L-carriers have almost three times more risk of relapse when compared with SS carriers.