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Bipolar patients who develop suicidal tendencies are genetically conditioned

Bipolar disorder is a serious psychiatric condition very common, affecting about 2 or 3% of the general population. This disease also affects in sick leaves hospitalization and social problems. Many patients also present suicidal behavior. Patients who do not take drug treatments have high autolytic risk. It is estimated that the risk of death by suicide, particularly in unmedicated patients reaches 15%. Suicide is a very complex behavior which is believed that, like other psychiatric diseases, there are many small effect genes interact with each other and also interact with other types of environmental factors, psychological or psychosocial.

Researchers Bipolar Disorders Program of the IDIBAPS - Hospital Clínic, leded by Dr. Eduard Vieta, have published a study in the journal European Neuropsychopharmacology, which shows that there are genetic aspects determining suicidality of bipolar patients. Results approach suicide concept to a biological basis, bringing it closer to the disease. Dr. Antoni Benabarre is the principal investigator and the IDIBAPS predoctoral fellow, Esther Jimenez, the first signer.

In this study has been demonstrated that the presence of specific risk alleles or genotypes in some of the polymorphisms of the IMPA2 genes, INPP1 and GSK3ß, are associated with an increased risk of suicidal behavior in this group of patients. The genes involved are linked to signaling pathways related to the mechanism of action of lithium carbonate. This drug, which is one of the "pillars" of the pharmacological treatment of bipolar disorder, has been shown to have properties to prevent suicide, although not yet described exactly in which pathway or mechanism.

This is a basic research study but it has clinical applicability, since it could provide information on risk of death by suicide in subgroups of patients diagnosed with bipolar disorder. According to Dr. Benabarre: "These results could allow us to focus on a group of high-risk patients, who will can be treated in a special way, with the primary objective of preventing suicidal behavior". Esther Jimenez says the findings could "help us to establish a biological marker which will give more clues about who can become suicidal." The first author also speaks about future studies that "could make a subsection in the study of other populations, such as people who suffer unipolar depression, who also have very high rates of suicidal behavior".

Reference:

Jiménez E, Arias B, Mitjans M, Goikolea JM, Roda E, Sáiz PA, García-Portilla MP, Burón P, Bobes J, Oquendo MA, Vieta E, Benabarre A. Genetic variability at IMPA2, INPP1 and GSK3ß increases the risk of suicidal behavior in bipolar patients. Eur Neuropsychopharmacol. 2013 Feb 28. pii: S0924-977X(13)00046-1. doi: 10.1016/j.euroneuro.2013.01.007. [Epub ahead of print]