Jae-Min Kim1, Robert Stewart2, Sung-Wan Kim1, Hee-Ju Kang1, Seon-Young Kim1, Ju-Yeon Lee1, Kyung-Yeol Bae1, Il-Seon Shin1, Jin-Sang Yoon3. 1. Department of Psychiatry & Depression Clinical Research Centre, Chonnam National University Medical School, Kwangju, Republic of Korea. 2. Section of Epidemiology, Institute of Psychiatry, King׳s College, London, UK. 3. Department of Psychiatry & Depression Clinical Research Centre, Chonnam National University Medical School, Kwangju, Republic of Korea. Electronic address: jsyoon@chonnam.ac.kr.
Abstract
INTRODUCTION: The functional polymorphism in the serotonin transporter gene linked promoter region (5-HTTLPR) may modify associations between environmental stressors and suicidality in adolescents and working-age adults. We investigated whether the 5-HTTLPR s/l polymorphism interacts with stressful life events (SLEs) and social support deficits (SSDs) on late-life suicidal ideation. METHODS: 732 Korean community residents aged 65+ were evaluated and, of 639 without suicidal ideation, 579 (90.6%) were followed two years later. Prevalence and incidence of suicidal ideation was ascertained. Information on SLEs and SSDs were gathered, and covariates included socio-demographic characteristics, depressive symptoms, cognitive function, and disability. RESULTS: Significant interactions were observed between 5-HTTLPR genotype, SLEs and SSDs on both prevalence and incidence of suicidal ideation after adjustment for covariates. The associations of SLEs and SSDs with suicidal ideation were strengthened in combination with higher numbers of s alleles, and were only significant predictors in those with s/s genotype. A significant three-way interaction between 5-HTTLPR genotype, SLEs and SSDs was also found. LIMITATIONS: The generalizability of suicidal ideation as a marker of suicidality should be considered. CONCLUSIONS: Gene-environment interactions on suicidal behavior are therefore identifiable even in old age.
INTRODUCTION: The functional polymorphism in the serotonin transporter gene linked promoter region (5-HTTLPR) may modify associations between environmental stressors and suicidality in adolescents and working-age adults. We investigated whether the 5-HTTLPR s/l polymorphism interacts with stressful life events (SLEs) and social support deficits (SSDs) on late-life suicidal ideation. METHODS: 732 Korean community residents aged 65+ were evaluated and, of 639 without suicidal ideation, 579 (90.6%) were followed two years later. Prevalence and incidence of suicidal ideation was ascertained. Information on SLEs and SSDs were gathered, and covariates included socio-demographic characteristics, depressive symptoms, cognitive function, and disability. RESULTS: Significant interactions were observed between 5-HTTLPR genotype, SLEs and SSDs on both prevalence and incidence of suicidal ideation after adjustment for covariates. The associations of SLEs and SSDs with suicidal ideation were strengthened in combination with higher numbers of s alleles, and were only significant predictors in those with s/s genotype. A significant three-way interaction between 5-HTTLPR genotype, SLEs and SSDs was also found. LIMITATIONS: The generalizability of suicidal ideation as a marker of suicidality should be considered. CONCLUSIONS: Gene-environment interactions on suicidal behavior are therefore identifiable even in old age.
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